case-request-form

Request a Consultation

If you're facing discrimination or harassment at work, or have lost your job due to it, you need an experienced employment lawyer. Contact Melvin Kennedy Law Office now.

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*First Name

*Last Name

*Email Address

*Phone

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Phone (Optional)

Preferred Contact Method

Email Phone Either

Best Time to Contact You

*Your Employer

*Employer Address

Number of Employees

Under 15 15-100 over 100

*Your Title/Position

*Are You Still Employed Here?

Yes No

*Date of Hire

*Termination Date

Mark N/A if Still Employed

*Briefly describe the reason you are seeking legal representation:

Did you ever complain to the employer, a government agency, or to anyone else about the situation (of your complaint)? If so, please describe (if not, leave blank):

Do you have any evidence to support your claims? If so, please describe below:

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Is there anything else you would like us to know?

*How Did You Hear About Us?

If Referred, By Whom?

Disclaimer
Completion and submission of this form does not establish an attorney-client relationship.
Please indicate below that you have read and accept this.

*I have read & understand the disclaimer:

Yes