Law Offices of John Mikhail - Rastegar Law Group

Law Offices of John Mikhail Intake Form

Start by typing the lead name below.

First Name

Last Name

Phone

Email

Now please complete details below.

Describe the lead potential case.

What category does the lead potential case fall under?DiscriminationWrongful TerminationSexual HarassmentEqual PayPregnancy DiscriminationWage and HourRetaliationCivil RightsSexual AbuseSeveranceMedical DiscriminationI do not know

Defendant NameDefendant Location

Estimated Number of Employees at the Location

Lead Employment Status

Lead Preferred Language

Lead Preferred Communication

Marketing Source

Available fromTime

Available toTime

Available fromAvailable toCase Category