Civil Rights Case Inquiry Form

Do you believe that your rights under the Constitution or federal law have been violated? Please submit the information requested below, so that a Williams Cuker Berezofsky lawyer can help determine if you need legal representation.

* denotes required fields
Personal Information
* Name
* Address
City
State
Zip Code
Daytime Phone Number
Evening Phone
Mobile Phone
* E-mail Address
   
Case Information
How were your rights violated (check all that apply)?
 
excessive use of force by law enforcement (police brutality)
false arrest
wrongful conviction
malicious prosecution
termination of public employment
retaliation for speech or other exercise of rights
Other (Specify)
Date when your rights were violated
 
What injuries or losses have you suffered as a result of the civil rights violation?
 
Describe the circumstances of the violation of your rights.
 
 
* By typing "agree" into the below box you are confirming that you wish to send your information to Williams Cuker Berezofsky.