Employment Intake Form

The Law Office of Jeremy V. Reyes specializes in employment and housing law in the San Francisco North and East Bay areas. If you believe you have been wrongfully terminated, have wage and hour discrepancies, were wrongfully evicted or face repairs and habitability issues, please complete the intake form below. Please note: We do not represent employers, landlords, or persons seeking to evict others.

Employee Rights / Wage & Hour / Termination Questionnaire

← Back

Thank you for your response. ✨

Name

Phone

Legal Services Needed

Legal Services Needed if “Other” was selected above

County

County if “Other” Was Selected Above

Have you already contacted legal aid in your area?

If you have already contacted legal aid resources, list the organizations below. If you prefer not to answer, type “N/A.”

Please state the name of your employer/former employer.

Conflict of Interest Check

Please describe the reason you seek legal counsel.

Examples:
“I was terminated on or around _____ [state date]. I believe this was wrongful because ______ [state reasons].”

“I was not paid all wages owed to me.”

“I believe that employer is discriminating because ______ [provide details],”

What is the desired outcome?

Examples:
“I want someone to see if I can sue my employer for wrongful termination.”

“I would like to get all wages/benefits owing to me.”

“I want to sue the employer for damages.”

What written proof do you have of wrongful termination?

Examples:
“I have text messages.”
“I have a letter stating ______.”
“There is a Labor Commissioner letter/complaint stating ______.”

Is there any urgency for response? Please explain.

Examples:
“I have a labor commissioner hearing scheduled on _____.”

“A settlement offer from employer requires me to sign on or before _______ (state date).”

Do you have an attorney now, or at any time in the past, regarding this issue?

Select Yes or No

Do you have a file to upload?

Please click on the white box to add that below.

Drag and drop or click to select a file.

Contact The Law Office of Jeremy V. Reyes

Phone: (707) 815-0088
Email: info@jeremyreyeslaw.com
Fax: 888-400-0340
2300 Boynton Avenue, Suite 104 C, Fairfield, California 94533

Read our reviews on Yelp and Google!

Website Use Disclaimer

Home | Areas of Practice |
About | Schedule A Consultation