Contact Us

Consult/Referral Intake Form

First Name

Last Name

Phone

Federal Government Agency:

Is Your Position in the Bargaining Unit?

Are you a Dues Paying Bargaining Unit Employee?

Claim:

Have you made any management official in your chain of command, or other management official within the Agency, aware of your claim of discrimination?

Yes No

If yes, how and when did you make that management official aware?

Has any disciplinary action been taken against you, since making management officials within the Agency aware of your claim of discrimination?

Do you have any pending complaints against the Agency?

Yes No

What is the best time you can be reached to discuss your claim of discrimination?

Phone

(855) 576-4968 (855-LRM-4YOU)
(240) 576-4968 (240-LRM-4YOU)

email

[email protected]

Address

2800 Eisenhower Avenue, Ste. 220
Alexandria, VA 22314 (APPOINTMENT ONLY)

for consultation

Contact Us

Consult/Referral Intake Form

Phone

email

Address

for consultation