Case Evaluation Form

Southern California Sexual Harassment Case Evaluation Form

Welcome to the Hannemann Law Firm of Southern California Sexual Harassment Lawyer Brian G. Hannemann.

If you need quality, skilled representation in an employment law case, please fill out the following case evaluation form. Employment Attorney Brian Hannemann will call or email you promptly to make an appointment for a free in office consultation.

A pit bull trial attorney with over 25 years’ experience, Mr. Hannemann is a skilled and experienced negotiator and litigator who is devoted to protecting the rights of employees and helping them obtain maximum monetary compensation from their current or former employers.

For immediate assistance, call So Cal Sexual Harassment Employment Lawyer Brian G. Hannemann today at (909) 833-8999 to schedule a free consultation.

Name:

Email:

Phone (Home):

Phone (Cell):

City:

Address:

Zip Code:

What is the best time to contact you?

Please answer the following:

Describe the Sexual Harassment to which you were subjected:

Who was the perpetrator?

When did the Sexual Harassment Begin?

Please check the box if the answer is Yes

Did you report the harassment?
Have you discussed this with anyone else?

If yes, who did you discuss this with?

Please check the box if the answer is Yes

Are you currently undergoing psychiatric care as a result?
Are you currently in psychological counseling as a result?
Did you seek medical treatment as a result?

If you answered “yes” to any of the above, please provide the name of the Doctor:

Are you still working at the company where the Sexual Harassment took place and if not, please provide the circumstances of your separation: