Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 11DO YOU HAVE A CASE? Answer a few quick questions to help us determine if we can pursue justice on your behalf. What best describes your current work situation?I am being harassedI am being discriminated againstI am working in an unsafe environmentI was injured at workI was retaliated againstI am owed wagesI was wrongfully terminatedOtherNext Harassment *Sexual HarassmentPhysical Harassment (Unwanted Non-Sexual Contact)Verbal HarassmentNext Have you filed a complaint with the California Civil Rights Department (CRD) or Equal Employment Opportunity Commission (EEOC)?YesNo describe Equal Please Next Unsafe Work Environment *Dangerous Work SiteOffice in Need of RepairHostile Work EnvironmentNext Injured at Work *Filed a Workers Compensation ClaimDid Not File a Workers Compensation ClaimNext Retaliation *DemotedExcludedReassignedHours CutNext Owed Wages *Unpaid OvertimeUnpaid Paid Time Off (PTO)Unpaid BenefitsNext Discrimination *RacePregnancyReligionDisabilityGenderAgeMilitary or Veteran StatusMarital StatusNext Are You Still Employed *YesNo← Back Next Please describe what happened *← Back Next Name *FirstLastPhone *Email *Best Way To Reach You *TextPhone CallEmail← BackSubmit
