The Murphy Law Practice

New Client Form

Prospective Clients - Intake Form

Name *
Phone Number
Phone Number
Date Hired *
Date Hired
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?