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Waterside
Professional Building
221 E. Osceola St
Stuart, Fl. 34994
(772) 283-8260
(800) 329-4279
Fax # (772) 220-3343


W. E. Gary
Professional Center
320 S. Indian River Dr.
Ft Pierce, Fl. 34948
(772) 464-2352
(800) 330-2832
Fax # (772) 464-4226

 

Regions Bank Center 111 N. Orange Avenue Suite 1450
Orlando, Florida 32801 (407) 649-7171
Fax # (407) 649-7755

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Case Evaluation Form

Please complete and submit the form below.
Your case will be evaluated and we will respond to you shortly.

 

NOTE: An asterisk (*) indicates REQUIRED information. The use of the Internet or this form for communication with our firm or any individual member of our firm does not establish an attorney-client relationship.


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* Who is the case against?
* Have you discussed this
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* Do you already have an
attorney handling this matter?

If yes, why are you looking
for another attorney?
* Have you filed the matter
with any government agency?

If yes, which one?
* Have you received a right
to sue letter from the
EEOC or a determination
by a state agency?

If so, what is the
date on the letter?
* Date of incident:
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when was it filed?
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court dates?

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If discrimination, please
explain in detail the alleged
discriminatory conduct.

 

If employment, please
provide position and salary.


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OUR POLICIES

  • Our firm never releases any information given to us on these submission forms to any third party.
  • This is considered a completely confidential and privileged communication.
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