Questionaire Form - Pasternak Law

Interactive Questionnaire for Employment Related Problems

NOTE: Using this interactive questionnaire does not prevent or eliminate you from having a live call with one of our attorneys. You can always ask for a free telephone consultation.

Confirm Employment(Required)

Does this matter relate to your employment?
Note: This can be current or past employment, and it doesn’t matter whether you were called an employee or an “independent contractor.”

Yes

No

We’re sorry, but this interactive questionnaire is exclusively for employment-related issues. If your matter is not employment-related, please contact us at 415-693-0300, or HERE for a free consultation.

Still There?(Required)

Are you still working for this employer?

Yes

No

Nature of Your Problem(Required)

Please choose one option most relevant to the issue with your current or past employer. If there is more than one issue or other factors we need to know, please include that at the end of this form.

Fired/Quit(Required)

Were you fired? (this includes being "laid-off" or "let go") Or did you quit? (leave voluntarily)

Fired

Quit

Wrongful Termination Case(Required)

Is that the focus of your inquiry? You feel there was something wrongful about your termination?

Yes

No

If your answer is No please select a different option from point 3. in order to proceed further into questionnaire.

Nature of Your Problem(Required)

Please choose one option most relevant to the issue with your current or past employer. If there is more than one issue or other factors we need to know, please include that at the end of this form.

If Fired(Required)

When was the date you learned you were being fired?

Did they give you a reason for letting you go?(Required)

Did they give you a reason for letting you go?

Yes

No

Reason Given for Termination(Required)

Do you think the reason they gave was the real reason, just in terms of what motivated them to let you go?

Note: Answer “Yes” even if you think this was misguided or unfair; right now we’re just trying to figure out what their motive was.

Yes. They honestly believed the reason they gave me (though I disagree with the decision for other reasons)

No. I think the reason they gave was a false reason or “false cover” to hide another, true reason.

Real Reason for Termination(Required)

Why did they let you go?

Note: Again, we’re looking at it right now just based on their perspective. Even if you think they made a mistake, or didn’t understand, or something like that, please pick the option that best describes what they were thinking at the time.

Performance

Attendance

Reduction in force

Couldn’t perform work for medical reasons

Needed time off

Bad Fit/Personality conflict (example: the boss just didn’t like me)

No reason given

I had complained about something

Pretext Motive(Required)

What was the real reason they fired you?

If multiple options apply, pick the one you think was the primary reason.

Performance

Attendance

Reduction in force

Couldn’t perform work for medical reasons

Needed time off

Bad Fit/Personality conflict (example: the boss just didn’t like me)

Didn’t want to deal with my disability

I had complained about something

Unfair(Required)

If you feel this decision was wrong or unfair, please state (briefly) why:

Quit(Required)

Why did you quit?

Employer refused to provide you disability accommodations

Employer intentionally created or knowingly permitted intolerable working conditions

You felt discriminated against

Employer refused to provide time off

You were retaliated against for something you said or did

You felt harassed in the workplace

Retaliation - Cause(Required)

What action did you take that prompted your employer to retaliate against you?

Reported a violation of the law

Requested disability or religious accommodations

Opposed, reported, or participated in an investigation of workplace harassment or discrimination

Reported or tried to stop your employer from theft, fraud, or embezzlement of government funds

Retaliation - Retaliatory Action(Required)

What action did your employer take to retaliate against you?

Constructive Discharge(Required)

Please describe the intolerable working conditions

Wages(Required)

What is your issue?

Unpaid bonuses

Paid less than another employee who does substantially similar work but is of another gender, race, or ethnicity

Salary equates to less than hourly minimum wage

Salary does not account for overtime worked

Improper Background Check(Required)

How did the company provide notice of the background check?

Verbally

In small pieces of information provided throughout several written documents

In one written document which provided limited or no information to the content of the background check

In one written document which informed you of the scope and nature of the background check

The company did not provide notice of the background check

Other

How many employees were subject to background checks?(Required)

How many employees were subject to background checks?

Did you provide written authorization for the employee to conduct a background check?(Required)

Did you provide written authorization for the employee to conduct a background check?

Yes

No

Contract Issues(Required)

Are you a CBA employee or part of a union?

Yes

No

Is your pay salaried or hourly?(Required)

Is your pay salaried or hourly?

Salaried

Hourly

What is the issue with your contract?(Required)

What is the issue with your contract?

Contract of previous job preventing you from finding new work/accepting a new job (Non-compete clause)

Contract requires you to work overtime with no overtime pay

You believe a term of your contract is unlawful

Other

Unpaid Bonuses

Do you have any documentation of your employer promising you a bonus which you were not paid? If so, please upload said documentation here.

Drop files here or

Max. file size: 256 MB.

Salary Issues(Required)

What is your salary?

How many total hours do you work per pay period?(Required)

How many total hours do you work per pay period?

How many of those total hours are overtime? Overtime is defined as any additional time spent working after 8 hours in a workday, 40 hours in a workweek, or six consecutive days in a workweek.(Required)

How many of those total hours are overtime? Overtime is defined as any additional time spent working after 8 hours in a workday, 40 hours in a workweek, or six consecutive days in a workweek.

Proof of Intent(Required)

Why do you think this was due to your race, gender, religion, etc?

UntitledAre there any witnesses to your discrimination or harassment?(Required)

Are there any witnesses to your discrimination or harassment?

Thank you for your submission.

One of our attorneys will review it and get back to you promptly.

Your Name(Required)

Additional Factors(Required)

Please leave additional comments concerning any additional factors we need to know not already addressed in this form.

How would you like to be contacted(Required)

Email

Phone

Text Message

Any from above

Email(Required)

Email

Phone(Required)

Phone

Text Message(Required)

Text Message

Captcha

Name

This field is for validation purposes and should be left unchanged.

Interactive Questionnaire for Employment Related Problems

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