The Murphy Law Practice

New Client Form

Prospective Clients - Intake Form

Name *
Name
Phone Number
Phone Number
Date Hired *
Date Hired
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What proof do they have for different treatment: Documented, verbal, Text, etc.
Ever Written Up? *
Any performance evaluations? *
Did PC complain to Supervisor/HR *
Also was complaint in writing? Were there witnesses?
Date of termination
Date of termination
Person who did the firing
Person who did the firing
Request a soft or hard copy.
Should correspond with supporting evidence provided.
Date charge filed
Date charge filed
Have you applied for disability?
Have you applied for unemployment benefits?
Were benefits awarded?
Have you found a new job?
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