Dear Prospective Client,

Please complete the information below to allow our firm to evaluate whether you have a potential claim against your current or former employer. There may be instances where we will need additional information from you. If so, we will contact you.

The information you provide to us by submission of this case evaluation form is kept confidential and is protected by attorney client privilege even though you are not a client of the firm at this time.

You further understand that:

• No attorney-client relationship exists between you and The Law Office of Lantis G. Roberts, PLLC;
• To become a client of this firm a signed legal representation agreement must be executed by the firm, attorney, and potential client, and full payment of any required fee or retainer, as applicable, must be paid to the firm.

We make every effort to respond to every submission as timely as possible. Please allow at least 24 – 72 hrs for a response.