For Your Rights
In The Workplace

Documentation May Be Key To The Success Of Your Claim

At Johnson & Bennett, we represent employees who have been victims of discrimination, harassment, retaliation, or denied medical leave, or who may not have received all their pay from their employer. While we may look at other claims, typically, we represent employees asserting violations of Title VII of the Civil Rights Act, the Age Discrimination in Employment Act (ADEA), the Americans with Disabilities Act (ADA), the Family Medical Leave Act (FMLA), the Fair Labor Standards Act (FLSA) and related federal laws protecting employees against discrimination and harassment in the workplace.

All of these cases require proof in support of the allegations. And although isolated incidents can be grounds for a legal claim, it is usually far more powerful to demonstrate a pattern of wrongful actions over time. Doing this requires careful documentation. If you believe you have a claim, feel free to use the form below to begin documenting your case, which can then be submitted to us for review.

How To Submit Our Documentation Form

There are two ways to complete the following form:

1 » Use Our Word Document Template

  • First, you may try downloading and saving this Word document: Client Intake Form
  • Answer the questions in the document.
  • When finished, attach it to an email and send to [email protected].

2 » Cut And Paste Our Documentation Questions Into An Email

Alternatively, if you are unable to use the Word document, you may copy and paste the questions below into a new email. Simply answer each question and send to [email protected].

  1. Please provide your phone number and email you prefer to use.
  2. Where do/did you work? (state and city)
  3. Was someone of a different race, sex/sexual orientation/transgender status, age, national origin, or religion treated better in relation to the job action taken against you? Please specify.
  4. Do you have a disability or medical condition that could be protected under law?
  5. Does your matter involve denial of wages or request for medical leave?
  6. Please provide a short description of the actions that you believe were discriminatory, harassment, retaliation, denial of leave or related matter.
  7. When did the actions described above occur?
  8. What is the name of your employer?
  9. How long have you been/were you employed?
  10. Does the employer have more than 15 employees?
  11. How much money do/did you make?
  12. Why do you believe that it was discrimination, harassment, or retaliation?
  13. Did you report discrimination, retaliation, or harassment to your manager, HR, a hotline/designated complaint line, or anyone else at your job?
  14. When did you make the complaint? Did you make a written complaint? How was your complaint addressed by the company?
  15. After you complained, did anyone retaliate against you?
  16. Was the individual who received the complaint the same individual who took the adverse action against you?
  17. Have you been terminated, and, if so, what reason were you given for your termination?
  18. What do you believe to be the real reason for your termination, and what evidence do you have of that reason?
  19. Have you contacted the EEOC? If so, when? What is the status? Did you receive an inquiry number?
  20. If you filed an EEOC charge, have you received a right to sue (dismissal)? What is the date on the right to sue?

Please submit a copy of any documentation you may have to support your claims. Also, please include any information related to the EEOC if you have already begun or are in that process. Nothing in this email should be construed as any indication of our agreement to represent you. We simply need this additional information to make that determination. We may be in contact with more questions before making a final decision on your matter.

Contact Us With Your Documentation Questions

If you have questions or need additional help submitting our questionnaire, please contact our office at 769-207-0599 today. You may also ask other questions about how to document a workplace situation. We work with clients across western Tennessee and northern Mississippi from our offices in Memphis.