[firm-name] sponsors “Breaking the Silence” benefit

Questionnaire Form

We understand how difficult it is for you to tell your story of sexual abuse. But we want to listen, to hear you, and to help you on your path of surviving. In an effort to assist you, even if you are not yet ready to speak with an attorney, we are providing a screening intake. Should you want an opinion on your potential claim without the stress of speaking to someone about your situation, please answer the questions below. If at any time you want to speak to an attorney, our lawyers are ready to listen and guide you on the next steps of healing and ready to give you back your voice. If you are not ready to speak we will give you a written opinion on your potential claim free of charge.