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Intake Questionnaire

Confidential: Rest assured that the information you share with me on this page will remain confidential, regardless of whether you formally retain me as your attorney. Conversations and documents you share with an attorney when you are considering retaining one, but have not yet done so, are still covered by the privilege. See Evidence Code Section 951 (“As used in this article, ‘client’ means a person who, directly or through an authorized representative, consults a lawyer for the purpose of retaining the lawyer or securing legal service or advice from him in his professional capacity, …”)

Please answer the following questions, and upload the following documents, to the extent you can. The more information you provide in advance, the more informed I will be when we discuss your case.

    Name

    Email

    Phone

    Are you an independent contractor (1099) or employee (W-2)?

    Are you a current employee/contractor?

    When did you start working?

    If you are a former employee/contractor, when did your employment end?

    Did you sign an arbitration agreement required by your employer?

    Did you sign a written contract with your employer?

    Who is your employer?

    Are you salaried (flat sum each pay period) or hourly (fluctuates with number of hours worked in each pay period)?

    If salaried, what is your annual salary?

    If hourly, what is your hourly rate?

    Regardless of whether you are salaried or hourly, do you work overtime (typically anything over 8 hours per day or 40 hours per week)?

    If so, how much overtime do you work on average per day (typically anything over 8 hours per day)?

    Are you paid on commission?

    Are you a piece-rate employee?

    Are you given an opportunity to take an uninterrupted 30-minute meal break every 5 hours?

    Are you given an opportunity to take an uninterrupted 10-minute rest break every 4 hours?

    Do your paystubs reflect all hours actually worked (including overtime)?

    Are you alleging that your employer terminated you based on one of the following (please select all that apply):

    If you believe you were terminated based on a disability, did your employer participate in an interactive process with you to determine whether a reasonable accommodation could be made so that you could perform the essential job requirements?

    Have you filed an action with the DLSE or in Court?

    If so, when?

    Is there a pending hearing that you need representation at?

    If so, when?

    If you have a copy of your Employment Contract, please upload it here

    If you have a copy of a recent Paystub, please upload it here.

    If you have a copy of your Collective Bargaining Agreement, please upload it here.

    If you have a copy of your Arbitration Agreement, please upload it here.