Employment Law

Welcome to the Barsalou & Sebesta CasecheckJ Program. CasecheckJ is a part of the RealtimelawJ family of online legal assistance programs.

Please fill out the following questionnaire so we can better assist you.

Employment Questionnaire

Check all boxes that may apply:

Discrimination because of my race, religion, national origin, age, disability or gender (sex).
Sexual harassment.
Unwelcome physical contact or touching.
Failure to pay overtime wages.
Wrongful termination.
Termination because of filing a worker's compensation claim.
Other claim.
I am pregnant or recently had a child.
I am not being paid the same as other workers with the same skills.
I was fired for attending jury duty.

I have a clerical job but I am not paid overtime wages.

I have an illness or disability that affects my work.

I have filed an EEOC claim.

I have complained to my supervisor.

I was fired or terminated.

I quit.

Select Race:

Select Gender:

Select National Origin:

Select Age:

*Your Name
*Address *City & State
*E-mail
*Phone
*Date of First Incident
*Date of Last Incident
*Illness or Disability
*Social Security Number
*Texas Driver's License No.
*Date of Hire
*Date of Termination
*Supervisor's Name
*Reason Given for Termination
*Employer
*Number of Employees
*Employer's Address *Employer's Address

*Please Briefly Describe What Happened: