Intake Form

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Enter name of entity here
    Check the box (as many as needed)
  • Thank you for completing our Intake Form. Please save this form, updated with your responses above, and send it back electronically to the attorney or assistant who emailed it to you. Allow us some time to process your response, and we will reach back out to you either by phone or email within the next two (2) business days. By completing and submitting this form, you agree to Rodman Employment Law's Terms & Conditions, which you understand can be found on the Rodman Employment Law website at https://rodmanemploymentlaw.com/terms-and-conditions/.
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