Employment Questionnaire

Using the form below, please give us some of the basic information about your situation. Please take your time to answer the following questions as accurately and completely as possible. Please answer all questions that may apply to your situation. If a question is inapplicable, simply write N/A. At the end of the questionnaire there is additional room to supplement your answers or to add any additional information you think is relevant to your potential claim.

Please be advised that submitting this questionnaire does not create or constitute an attorney-client relationship between you and Kerry Murphy Law LLC. By clicking “submit,” you agree that any subsequent communication between us is not intended to convey or constitute legal advice, or to provide a substitute for obtaining legal advice from a qualified attorney, and will not constitute an attorney-client relationship unless we have entered into a written agreement to represent you.

  • Your Information


  • Employment Information

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY

  • Case Information

  • Examples: Sexual harassment because of constant unwanted advances; racial discrimination from being passed up for promotions; retaliation for complaining about discrimination in the workplace; failure to pay overtime or other wages.
  • Please be detailed: include specific incidents, dates, people involved, actions you have already taken, etc.
  • Information not covered above that you think we need to know

KERRY MURPHY LAW LLC
715 GIROD STREET, SUITE 250
NEW ORLEANS, LA 70130

PHONE: (504) 603-1500
FAX: (504) 603-1503
INFO@KERRYMURPHYLAW.COM