Thank You Your message has been successfully sent. If you’d like to include more information about your case, please do so below. NameEmailPhoneAbout the IncidentWas this a single incident or ongoing? Choose an optionSingle incidentOngoing Was the person who assaulted you someone you knew? (e.g., friend, coworker, teacher, romantic partner, stranger, etc.) Choose an optionFriendCoworkerTeacherRomanticPartnerStrangerClergyOther OtherWhere exactly did the assault occur? Choose an optionChurchDetention CenterTreatment FacilityA Private HomeWorkplaceHotelInstitutionOther Other:Were there any witnesses or people you told at the time? Choose an optionYesNo About the PerpetratorDo you know the name of the person or people responsible? Choose an optionYesNo Were they in a position of power or authority over you? (e.g., employer, coach, religious leader, etc.) Choose an optionYesNo Do you believe this person may have harmed others as well? Choose an optionYesNo ImpactWhat impact has this had on your life? (e.g., emotional, physical, financial, career, etc.) Have you received medical or mental health treatment as a result? Are you currently in a safe place? ReportingHave you reported this to law enforcement or any other authority? (e.g., police, Title IX, HR, CPS, etc.)Choose an optionYesNoOtherOtherIf yes, what was the outcome of that report (if any)? Legal ConsiderationsAre you interested in pursuing a legal claim or lawsuit? Choose an optionYesNo Is there a specific institution, company, or entity you believe should be held accountable? More About YouIs there anything else we need to know about you or what happened that would help us better serve you?I understand that submitting this form does not create an attorney-client relationship. I also understand that Miller & Zois works with multiple law firms on these claims and that I may be contacted by an affiliated law firm working with Miller & Zois on these lawsuits. Contact Us Now
Lawsuit Information Center