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Home
About
The Firm
Reviews
Scholarship
Attorneys
Omid Nosrati
Rene Maldonado
Amir Navab
Soledad Nunez
Jaime Castaneda
Staff
David Mateo Santiago – Paralegal
Sav Reisfelt – Paralegal
Citlali Arroyo – Law Clerk
Emily Padilla – Law Clerk
Catherine Castaneda Armenta – Legal Assistant
Jenefer Dang – Intake Coordinator
Practice Areas
Wrongful Termination
Sexual Harassment
Discrimination
Retaliation
Wage and Hour Disputes
View All
Results
Service Areas
Los Angeles
Long Beach
Santa Clarita
Glendale
Lancaster
Palmdale
Pomona
Resources
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Articles
Media Center
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Contact
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Intake Form
All Information Below is CONFIDENTIAL
EMPLOYEE INFORMATION
Name
First
Date
MM slash DD slash YYYY
Email
Phone
EMPLOYER INFORMATION
Name of Employer
Approximate # of employees
Your job title
Are you part of a union? If so, which one
Type of Business
What was your salary or hourly wage?
Date of Hire
MM slash DD slash YYYY
Date of Termination
MM slash DD slash YYYY
If you were terminated, did you receive severance pay (more than the wages and vacation pay you were owed)?
Did you sign a written release when your employment ended?
Did you sign an arbitration agreement?
Do you believe the employer still owes you money for unpaid wages?
What type of unpaid wages?
Regular Hours
Overtime Hours
Unpaid Vacation
What type of Wrongful Action are you claiming?:
Termination
Failure to Promote
Demotion
Failure to Hire
Harassment
Unsafe work conditions
Failure to Pay Wages
Failure to provide meal breaks or rest breaks
Other
REASONS FOR WRONGFUL CONDUCT
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DISCRIMINATION
Do you believe that the employer's wrongful action was the result of discrimination based on one of the following? (Please check if applicable)
Sex
National Origin
Race
Disability
Disability Description
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Pregnancy
Was the employer aware of the pregnancy?
Sexual Harassment
Age
Retaliation
Whistle Blowing (i.e., complaining about illegal conduct by your employer or refusing to do something illegal)
Sexual Orientation
Other (describe)
Other Discrimination
If you feel you have been discriminated against based on one of the above, please give specific examples that show that the unfair treatment is caused by the discrimination (such as, discriminatory remarks, different or unfair treatment, under-representation, etc.)
Discriminations Examples
Please state if any witnesses to the discrimination and briefly describe what they might testify to:
JOB PERFORMANCE
Evaluations
Wrongful Action(s)
Written Notice(s)
Phone
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PRACTICE
AREAS
Workplace Discrimination
Age Discrimination
Disability Discrimination
National Origin Discrimination
Pregnancy Discrimination
Race Discrimination
Religion Discrimination
Sexual Orientation
Gender Discrimination
EEOC
Retaliation
FMLA Retaliation
Reporting Fraud
Reporting Harassment and Discrimination
Taking Medical Leave
What is Employer Retaliation in California?
Hostile Work Environment
Sexual Harassment
Wage and Hour Disputes
California Family Rights Act
Class Actions
Family and Medical Leave Act
Failure to Reimburse Expenses
Meal and Rest Violations
Medical Leave
Misclassification as Exempt Employee
Paid Disability Leave Law
Paid Family Leave
Unpaid Overtime
Prevailing Wage
Wrongful Termination
Wrongful Termination For Using FMLA Leave
Wrongful Termination for Reporting Fraud
Wrongful Termination for Seeking Payment of Wages
Wrongful Termination for Reporting Harassment & Discrimination
Wrongful Termination After Taking Sick Leave
Whistleblower Protection
California Wrongful Termination Law
Do I Have a Wrongful Termination Case?