Contact Us | Strianese Huckert LLP

If you are interested in legal representation, we encourage you to fill out and submit the Case Evaluation Form below. If you would like to speak with us by phone, you are always welcome to call our office at 704-966-2101. We will be happy to speak with you and set up a time for an in-person consultation. However, with new clients, we will generally request that you fill out the below Case Evaluation Form prior to the consultation. This will help us to understand your situation and allow us to better use our time together.

All Information Submitted In This Form Will Be Kept CONFIDENTIAL By Strianese Huckert LLP
(Please Use The Tab Key To Move Between Fields)

I. Personal Information

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Phone*

Do you still work for the Employer you are contacting me about?

Yes
No

If not, when was your last day of employment?

My position title was/is

My total compensation (salary, bonus, commissions, etc.) with the Employer/Former Employer I am contacting you about was/is approximately

II. Information About Your Employer or Former Employer

Employer Name:

Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employer Size (nationwide):

III. Nature of Your Claim(s) (please check all that apply)

I am contacting you about:

Sexual Harassment
Gender Discrimination
Race or National Origin Discrimination
Age Discrimination
Religious Discrimination
Pregnancy Discrimination
Retaliation
Wage and Hour Claim
Whistleblower Claim

Other: Please explain:

(If you are contacting me about a non-competition, non-solicitation, or trade secret case, an employment or severance agreement matter, or are interested in mediation services, please call me at 704-966-2101.)

I have been:*

Fired
Demoted
Sexually Harassed
Denied a Promotion
Employer Refused to Hire Me
Paid in a Discriminatory or Illegal Manner

Other: Please explain:

Did the employer give a reason for the action they took against you?

Yes
No

If yes, what was their stated reason?

The most recent date on which I was subjected to discrimination, harassment, or other illegal conduct was:

I have complained to my employer/former employer about the discrimination, harassment, or other illegal conduct I am contacting you about:

Yes
No

Are you aware of any other current or former employees at your employer/former employer who have been subjected to the same kind of discrimination or harassment as you?

Yes
No

Have you already filed an EEOC charge or lawsuit because of the discrimination, harassment, or other illegal conduct you experienced?

Yes
No

Besides the current dispute or legal issue, have you ever been involved in any legal disputes or litigation in the past?

Yes
No

IV. Case Summary

Please briefly describe and explain the legal dispute or issue you are contacting me about. Why do you believe that you have a claim against your employer/former employer? Why are you interested in hiring an attorney?

Is there anything else you would like to tell me?

I understand that submitting this Case Evaluation Form does not establish an attorney-client relationship with Strianese Huckert LLP or attorneys Chris Strianese or Tamara Huckert. I understand that an attorney-client relationship can only be established through the execution of a retainer agreement.

*

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I. Personal Information

II. Information About Your Employer or Former Employer

III. Nature of Your Claim(s) (please check all that apply)

IV. Case Summary