This form is for employees. The intake form for employers can be found here. HiddenNext Steps: Sync an Email Add-OnTo get the most out of your form, we suggest that you sync this form with an email add-on. To learn more about your email add-on options, visit the following page (https://www.gravityforms.com/the-8-best-email-plugins-for-wordpress-in-2020/). Important: Delete this tip before you publish the form.About YouYour Name(Required) First Last Home Address Street Address Address Line 2 City Postal Code Business Address Street Address Address Line 2 City Postal Code How Can We Reach You?Preferred Method of ContactEmailPhoneYour Email Address(Required) Email Address Confirm Email Address Your Phone(Required)Best Time to Call You(Required)Select A Time12:00 am12:30 am1:00 am1:30 am2:00 am2:30 am3:00 am3:30 am4:00 am4:30 am5:00 am5:30 am6:00 am6:30 am7:00 am7:30 am8:00 am8:30 am9:00 am9:30 am10:00 am10:30 am11:00 am11:30 am12:00 pm12:30 pm1:00 pm1:30 pm2:00 pm2:30 pm3:00 pm3:30 pm4:00 pm4:30 pm5:00 pm5:30 pm6:00 pm6:30 pm7:00 pm7:30 pm8:00 pm8:30 pm9:00 pm9:30 pm10:00 pm10:30 pm11:00 pm11:30 pmAbout your employment issuePlease let us know what is concerning you and some details about your employment situation.Are you currently employed? Yes No Name of your employer?(Required) Title of your position? How many years of service?Your rate of pay? What is your age?18-2425-3435-4445-5455-6465 or AbovePlease tell us about your issue or concern.(Required)Upload documents Drop files here or Select files Accepted file types: pdf, docx, odt, xlsx, ods, jpg, jpeg, png, Max. file size: 32 MB, Max. files: 5. Please upload your employment contract, termination letter, and/or other documents relevant to your question or claim.Acknowledgement(Required)Submitting this form or sending an email does not constitute a retainer or a solicitor-client relationship, not does it create a reasonable expectation that Massey LLP undertakes to provide legal advice, legal services, or legal representation. You will not be considered a client of Massey LLP unless and until we had agreed to act for you, which we will confirm in writing. I understand that this does not constitute a retainer or a client-solictor relationship. PhoneThis field is for validation purposes and should be left unchanged.