Contact O’Brien & Marquard PLC

Case Review Form

Using the form below, please provide us some of the basic information about your situation. We will then contact you by phone to discuss confidentially. Depending on the nature of your case, we may be able to offer representation on a contingency fee basis.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Employer

Employer’s City & State

Why are you contacting our office?

Date Employment Started

YYYY

Date Employment Ended (if applicable)

YYYY

Why do you believe you were discriminated against or paid improperly?

Is there any other information that we need to know?

Your submission of this case review form does not create an attorney-client relationship between you and the attorneys at O’Brien & Marquard, P.L.C. O’Brien & Marquard, P.L.C. keeps all submitted information confidential.

Our Office

Davenport Office
2322 E. Kimberly Road
Suite 140S
Davenport, Iowa 52807
Phone: 563-355-6060
Fax: 563-355-6666