Section 1: Quick Context
Just a heads up that this Assessment will take about 10 minutes. We want you to just do this once and do it well because the better your answers the more accurate our assessment will be for you. Also, before getting started, if you have your Separation Agreement please locate as we'll ask you a few questions about that.
What best describes your current situation
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I was terminated by my employer
I recently quite
I'm still employed
Were you offered a severance package?
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Yes
No
Not Sure
Did you accept or sign the severance package?
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Yes
No
How many days were you given to review or respond to the severance offer?
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What was the severance amount offered (USD)?
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Has your employer provided a written explanation for your termination?
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Yes
No
What reason did your employer give for your termination?
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Misconduct
Performance
Layoff
Reduction in force
Not clear / Not stated
Other
If you were given an explanation verbally, please describe what was said. If you weren't provided a verbal explanation, simply put "N/A".
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Section 2: Employment Background
What was your job title?
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What was your start date?
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What was your end date?
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What was your work arrangement?
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Fully remote
In-office
Hybrid
Field Work
What was your final annual salary (USD)?
Approximately how many employees work at your company?
When you was your last promotion?
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If never promoted, say "N/A"
How would you describe your most recent performance review(s)?
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Excellent
Good
Below Expectations
Mixed
No recent reviews
Were you ever placed on a Performance Improvement Plan (PIP)?
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Yes
No
Not sure
Have others been laid off or terminated recently?
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Just me
A few
Many
Not sure
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Section 3: Company Details
What is your company name?
What is your company website?
What state did you live in?
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What state did you work in?
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What industry does your company operate in?
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Section 4: Severance Agreement Details
Does your severance agreement include any of the following obligations?
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Non-compete
Non-solication
Confidentiality
Non-disparagement
None
Not sure
Is your healthcare contingent on signing your separation agreement?
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Yes, it is contingent
No, healthcare is being continued regardless if I sign my separation agreement
N/A - my employer is not offering to continue healthcare
Not sure
What type of health insurance continuation was offered?
No continuation
COBRA at own cost
Employer paid COBRA (full or partial)
Extended active coverage
Lump-sum healthcare stipend
If there is a continuation, how many months will your company be paying or contributing?
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Is your job search or outplacement support contingent on signing your severance agreement?
Yes
No
Are unused vacation or PTO being paid out?
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Yes
No
Not sure
Did your severance agreement mention releasing future claims or legal rights?
Yes
No
Not sue
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Section 5: Compensation, Equity & Employment Agreements
Did you sign an employment agreement?
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Yes
No
Not sure
If yes, do you have a copy of it?
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Yes
No
Not sure
Does your employment agreement entitle you to payments if terminated without cause or for good reason?
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Yes
No
Not sure
If yes, what amount or formula applies?
Do you have a copy of your company's employee handbook?
Yes
No
Not sure
Do you hold any equity or stock options?
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Yes
No
Not sure
Do you have copies of your equity or stock documents?
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Yes
No
Not sure
Did you earn or were you about to earn a sum of money (bonus, commission, or equity)?
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Yes
No
Not sure
Please describe the circumstances and the amount you believe you had earned or were about to earn.
Were any verbal promises made about job security, bonuses, or severance that weren't document?
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Yes
No
Not sure
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Section 6: Potential Violations or Legal Exposure
Do you believe any of the following wage and hour violations occurred during your employment?
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Unpaid overtime
Off-the-clock work
Unpaid final wages
Unpaid commissions
Unpaid bonus
Misclassified as exempt
Meal / rest break violations
Unreimbursed business expenses
No wage violations
Other
Are you aware of any legal, financial, or reputation issues affecting your company?
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Employment lawsuits
Regulatory or compliance issues
Financial difficulties
Mass layoffs or restructuring
Negative media coverage
Leadership scandals
No known issues
Other
Are there cultural or organization issues that could create legal exposure?
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Toxic workplace
Dysfunction HR
Systemic policy violations
Widespread wage & hour violations
Safety or health violations
Unusually high turnover
Other systemic programs
No majory systemic issues
Other
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Section 7: Discrimination, Retaliation & Timing
Have you observed or experienced unfair treatment toward certain employees or groups?
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Yes
No
Not sure
Have you observed or experienced discrimination patterns?
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Age
Gender
Race or ethnicity
Disability
Pregnancy
Other
None
Please briefly describe why you believe a protected characteristic may have played a role in your termination.
Did your termination occur at a suspicious time?
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Shortly after filing a complaint
After requesting / taking medical leave
After pregnancy announcement
After reporting legal violations
Sudden performance issues after complaint
No suspicious timing
Other
Please briefly describe why you believe timing or actions played a role in your termination.
Did your employer ever retaliate after you raised a concern or asked for something protected by law (like medical leave, accommodation, or pay transparency)?
Yes
No
Not sure
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Section 8: Sequence of Events & Supporting Evidence
Please share what happened leading up to your termination and what evidence you have. You don't need to write a novel - just key events and documents are helpful.
Please describe the sequence of events in the 1 - 3 months leading up to your termination.
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What evidence do you have to support potential legal claims?
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Performance reviews and metrics
Positive feedback
Emails, texts, or written communication
Video or audio recordings
Colleagues who witnessed issues
Records of complaints
Medical records / accomodation requests
Company policies or handbooks
Offer letter / employment contract
Limited evidence
No evidence
Please explain what evidence you have and how it's relevant.
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Section 9: Legal Classification & Final Details
Were you classified as an at-will employee?
Yes
No
Not sure
Union represented
If you were not an at-will employee or a union represented employee, please describe your employment designation.
Were employees with similar performance or tenure treated differently during layoffs or terminations?
Yes
No
Not sure
Do you feel your termination was handled fairly overall?
Yes
No
Not sure
Please briefly explain what made your stituation feel unfair or inconsistent compared to others.
How would you like us to help you from here?
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Understand if my severance is fair
Get legal help to review or negotiate my severance
Explore potential legal claims
Just gathering information
Email
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Required so we can email you the Report.
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