Family & Medical Leave Act

The federal Family and Medical Leave Act (FMLA) allows eligible employees up to 12 unpaid weeks off from work when they are unable to work because of serious illness, or after the birth or adoption of a child, or to care for a spouse, child, or parent with a serious health condition.  If you believe your rights under this law have been violated by your employer, please take a few moments to fill out the form below.

If you are unsure of a question, hover the mouse pointer over the small red question mark next to the question for additional guidance.  After you have completed the form, type in the code at the bottom of the form and click on the SEND button (next to the box where you enter the code).

Completing this form does not create an attorney-client relationship. While the information you have provided is privileged and confidential, we do not represent you until we enter into a written agreement. We will review your submission based on the information you provide to determine whether you have a viable claim.

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