Employment Law Intake Form

*Name:

*Address:

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*E-mail address:

*Home Phone:

Business Phone:

Cellular or Pager:

Facsimile:

Are you known by any other names?
Yes  No 

If yes, list other names you have used:

What is your marital status?

Does this matter involve a business you own or run?
Yes  No 

If yes, provide the business name, address, and phone:

If a business is involved, how is the business organized (if known)?

Are you employed?
Yes  No 

If yes, please provide your job title and employer's name and address.

Can you be contacted at work?
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What area of law does your situation involve (if known)?

Describe your situation, including any relevant dates:

How would you rate your legal needs described here?

Are any other people involved?
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If yes, provide names, addresses (if known), and their relationship to you, if any:

Do you have any documents that could help explain your situation?
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If yes, list those documents and their dates:

Are there other documents that you do not have access to that could be of assistance?
Yes  No 

If yes, list those documents and their dates and locations (if known):

Describe how this situation has impacted you:

Describe what you would like to happen to resolve your issue (your preferred outcome):

Have other attorneys worked on this matter?
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If yes, provide names, addresses, and a brief description of their involvement:

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Office Location 1010 Common Street, Suite 3000
New Orleans, LA 70112
Direct Line: (504) 525-2520
Fax: (504) 581-7083

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Based in New Orleans, employee rights attorney James L. Arruebarrena represents employees throughout Louisiana including the cities of New Orleans, Metairie, Baton Rouge, Lafayette, Hammond, Covington, and Slidell. As an employment lawyer who represents employees, Mr. Arruebarrena's representation also includes most parishes in Louisiana, including Jefferson, Orleans, St. Tammany, and Tangipahoa.

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