Contact Us today:
Delegal Law Offices, P.A.
424 East Monroe Street
Jacksonville, FL 32202
(904) 633-5000
(904) 358-2850 Fax
Protecting Careers is Our Business.
The Jacksonville, Florida attorneys at Delegal Law Offices represent employees in a wide range of employment law concerns. Our clients come from the Greater Jacksonville area and Northeast Florida, including the counties of Nassau, Baker, Flagler, Duval, St. Johns, and Clay, and from communities such as St. Augustine, Ponte Vedra Beach, Jacksonville Beach, Palm Valley, and Orange Park.
Severance Agreements - Questionnaire
For review of severance agreements, please contact our office to schedule a time to meet with an attorney. The information needed to evaluate post-severance agreements usually must be discussed in person during a conference with an attorney. We charge an initial $350 to review an agreement and to provide consultation services regarding such an agreement. If you wish to ensure the confidentiality of any information you provide to us, please call our office for an in-person consultation with one of our attorneys, instead of completing this internet questionnaire.
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Name:
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Address (include city, state and zip):
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Telephone:
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- Home
- Work
- Cell
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Email address:
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Confirm email:
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Date of birth (MM/DD/YYYY):
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Place of birth:
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Gender:
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U.S. Citizen?
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Employer whom you are contacting us about:
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Address of employer:
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Rate of Pay:
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per
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Hire Date:
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General description of the terms of the severance agreement
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How did you learn of our firm?
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If an attorney referred you, what is the name of the attorney or firm?
If another person referred you, what is that person's name?
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Additional Information
Please provide any additional information about yourself or the case which would help the attorneys understand your potential case or explain your answers to the above questions.
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Scheduling
We will contact you by phone or email unless you request some alternate means of communication.
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PLEASE READ THE FOLLOWING STATEMENTS AND INDICATE YOUR ACCEPTANCE OF THESE TERMS PRIOR TO SUBMITTING THIS FORM.
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I have prepared the answers to these questions and to the best of my ability.
I understand that the submission of this form does not create any obligation for me or for any attorney at Delegal Law Offices.
I further understand that submission of this form does not create an attorney-client relationship and that the lawyer is not obliged to schedule a consultation with me.
I understand and agree that Delegal Law Offices, P.A., will have no duty to keep confidential the information that I am transmitting to the law firm through this questionnaire.
YOU MUST AGREE OR YOU CANNOT SUBMIT THE FORM!
I do not agree I agree
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Please answer this simple math problem to prove you are not a computer.
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By submitting this application, I understand that I am providing information to Delegal Law Offices, P.A. for its review of my case, but that Delegal Law Offices, P.A. has not provided me with any legal advice and is not serving as my attorney for any purpose unless and until Delegal Law Offices, P.A. enters into a contract to provide me with legal services. I further understand that I am not a client of the firm and expect no legal services to be performed on my behalf. By submitting this application, I understand that I am not obligating any specific action to be taken by the Delegal Law Offices, P.A., and I have not been promised that any specific services will be given to me.
Tad Delegal is Board Certified by the Florida Bar in Labor & Employment Law and State & Federal Administrative Practice.
Martindale-Hubbell AV Rated
An AV Rating from Martindale-Hubbell is recognized as the highest rating that an attorney or a law firm can receive. This rating is achieved through the confidential voting of our peers and members of the judiciary.