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Describe your needs below to get matched to Lawyers in your area.
My role *
What is your role in this incident?
Please describe the circumstances of the discriminatory action (location, individuals involved). Keep your description general and do not include names of anyone involved. *
Please briefly describe the specific action(s) that you feel constituted discrimination. *
Please briefly describe the reason, if any, given for the action(s). *
Discrimination type *
On what basis do you feel that you were discriminated against? Check all that apply:
Marital Status
National Origin
Pension or Other Benefit Status
Sexual Orientation
Union Membership
Workers Compensation Claim
Please briefly describe the injuries, damages or losses you have suffered as a result of this discrimination. *
When did you become aware of the discriminatory action? *
Billing preference *
Please indicate how you would prefer to to pay for the services of an attorney, should you hire one to help you with your legal matter. Note: there is no charge to sumbit your request.
Hourly Rate
Flat Fee
Not Sure
Location *
I want responses from Lawyers that serve:
ZIP Code:  -- OR --
I acknowledge that I have read and I agree to the TERMS AND CONDITIONS of this service *
I acknowledge that I have read and I agree to the TERMS AND CONDITIONS of this service
Contact Information:
First Name:*
Last Name:*
Day Time Phone:* ()-x
Evening Phone:  ()-
Best Time:*
Comments or Details: 
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How Does It Work?

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