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Do You Have a Case?

Case Evaluation Form

*Name:

*Address:

*City:

*State:

*Zip:

*E-mail address:

*Home Phone:

Business Phone:

Cellular or Pager:

Facsimile:

Please provide the name and address of the employer involved:

Are you a current
employee former employee job applicant or prospective employee of this employer?

Are you presently employed?
Yes No

If yes, please provide your job title and employer's name and address.

Can you be contacted at work?
Yes No

Describe your situation, including any relevant dates:

Are you a union member?
Yes No

If yes, provide the name, address, and local number:

Have you made a complaint about your situation to any governmental agency?
Yes No

If yes, provide the name of the agency, the date you made your complaint, and the final result, if any, of your complaint:

Are any other people involved?
Yes No

If yes, provide names, addresses (if known), and their relationship to you, if any:

Do you have any documents that could help explain your situation?
Yes No

If yes, list those documents and their dates:

Are there other documents that you do not have access to that could be of assistance?
Yes No

If yes, list those documents and their dates and locations (if known):

Describe how this situation has impacted you:

Describe what you would like to happen to resolve your issue (your preferred outcome):

Have other attorneys worked on this matter?
Yes No

If yes, provide names, addresses, and a brief description of their involvement:

Special concerns:

Where did you hear about this website?

*To which attorney were you referred, if any?:

 

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Abogados de Empleo

The law firm of Shellist Lazarz in Houston, Texas specializes in employment law. We have a nation-wide practice that represents employers and employees across the United States and throughout Texas including Dallas, Fort Worth, San Antonio, Austin, Galveston, Pasadena, Bellaire, Arcola, Baytown, Port Arthur, College Station, Brownsville, Beaumont, Orange, Vidor and McAllen.

Friday, May 9, 2008

 
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Shellist Lazarz LLP is not affiliated with the Equal Employment Opportunity Commission.

If you wish to contact the EEOC, please click the link below.

EEOC
 
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