Your Utah County law firm for over 50 years.

Case Evaluation Form

*Name:

*Address:

*City:

*State:

*Zip:

*E-mail address:

*Home Phone:

Business Phone:

Cellular or Pager:

Facsimile:

Please provide the name and address of the employer involved:

Are you a current _______ of this employer?
employee   former employee   job applicant   prospective employee 

Please provide dates of emloyment:

List all position(s) held at this company:

How many employees work for this company?
Under 15   15 to 50   50 to 100   100+ 

Describe your situation, including any relevant dates:

Are you a union member?
Yes  No 

If yes, provide the name, address, and local number:

Have you made a complaint about your situation to any governmental agency?
Yes  No 

If yes, provide the name of the agency, the date you made your complaint, and the final result, if any, of your complaint:

Are any other people involved?
Yes  No 

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?
Yes  No 

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?
Yes  No 

If yes, provide names, addresses, and a brief description of their involvement:

Special concerns:

Referred to our office by:

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Serving clients in Northern and Central Utah, across the Wasatch Front, along the I-15 Corridor, and Southern Utah including the cities of Salt Lake, South Salt Lake, Provo, Orem, Ogden, Logan, American Fork, Cedar Hills, Delta, Eagle Mountain, Saratoga Springs, Ephraim, Fillmore, Heber City, Lehi, Lindon, Manti, Mapleton, Nephi, Park City, Payson, Pleasant Grove, Price, Richfield, Roosevelt, Spanish Fork, Springville, Duchesne, Payson, Santaquin, Genola, Tooele, West Valley, West Jordan, South Jordan, Sandy, Draper, Midvale, Cedar City, St. George, Moab, Kanab, and Vernal.

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Contact Us

Office Address:
290 W. Center St.
Provo, UT 84603

Mailing Address:
P.O. Box L
Provo, UT 84603-0200

T. 801.373.4912
F. 801.373.4964 or 801.371.6964

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