Employment Case Evaluation - Shirian Law (Wrongful Term Focused)

1

Were you recently terminated from your job?* This field is required.

Yes, Terminated within last 6 months

Yes, Terminated within last 12 months

Yes, Terminated within last 2 years

No

2

What was your employment status?* This field is required.

Hourly

Salary

Independent Contractor

3

Do you live in California?* This field is required.

Yes

No

4

Have you ever experienced any form of discrimination, sexual harassment, or retaliation at your workplace?* This field is required.

Yes

No

5

Tell us a little bit about what you are experiencing in the workplace?(Optional)

6

Was your meal or rest break ever missed, cut short, late, or interrupted?* This field is required.Example: Your supervisor would ask you work related questions or for tasks during a break

Yes

No

7

Were you required to complete work tasks before clocking in or after clocking out?* This field is required.Example: Putting on a work uniform before clocking in

Yes

No

8

What is your preferred contact time?* This field is required.

As soon as possible

Early Morning (6:00am - 8:59am)

Morning (9:00am - 11:59am)

Afternoon (12:00pm - 4:59pm)

Night (5:00pm - 8:00pm)

9

What is your preferred contact information?* This field is required.This will remain completely confidential, but it helps us know how to address you.

First Name

Last Name

Please enter your email

Please enter your phone (xxx-xxx-xxxx)

10

Lastly, please provide the company name of your employerOptional, but this helps our research team get you the most compensation

Please enter company name or website information

11

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12

utm_source

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utm_campaign

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utm_term

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utm_content

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initial_referring_firm

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State of Work

18

Preferred Language