HomeA few more details please…A few more details please… We are currently experiencing high levels of enquiries.In order for us to process your enquiry more efficiently, please answer the following questions. We should then be able to get your case in front of a lawyer sooner rather than later. First Name*Last Name*Email* Phone (Mobile in most cases)*Details of claimWhat type of case do you have?*What type of case do you have?EmploymentBreach of ContractBusiness DisputeDefamation LawLandlord & TenantNegligence LawNuisance LawMedical NegligencePersonal Injury LawProfessional NegligenceProperty LawIntellectual PropertyPartnership DisputeShareholders DisputeInsolvency LawData ProtectionPrivacyConsumer LawNegligent MisstatementMisrepresentationOtherAre You Still Employed?*NoYesWhat was your length of service with the company?*What was your length of service with the company?Less than two years2 - 5 years5 - 10 years10 - 15 years15 - 20 years20+ yearsWhat is your length of service with the company?*What is your length of service with the company?Less than two years2 - 5 years5 - 10 years10 - 15 years15 - 20 years20+ yearsWhat is the general nature of the enquiry?*What is the general nature of the enquiry?Problems at work - general adviceOffered a settlement agreementDiscriminationGoing through a disciplinary/appeal processGoing through grievance processUnlawful deduction of wagesWhistleblowingHealth & SafetyOtherWere you dismissed or did you resign?*Were you dismissed or did you resign?DismissedResignedReason your employer gave for your dismissal?*PLEASE NOTE: Redundancy is also considered a dismissal under employment law.Reason employer gave for dismissal?ConductPerformance/CapabilityRedundancyRetirementIllegality (for instance statute)Ill-healthSOSROtherBrief Details of Dismissal*Please concisely set out why you were dismissed and why you believe your dismissal was unfair. For instance, I was dismissed for alleged theft, but the I deny that I stole anything and the CCTV footage is inconclusive.Did the company carry out a disciplinary process?*YesNoDid the company carry out a redundancy consultation?*YesNoBrief details of Resignation*Please concisely list the reason(s) for your resignation and in particular give details of the 'final straw' which made you resign.Did you raise a grievance prior to resignation?YesNoPlease give brief details of why you chose not to raise a grievance?*Does your case fall into any of the following categories?*You have limited rights with less than two years service. Does your case fall into one of the categories listed?Does your case fall into any of the following categories?NoDiscrimination/Harassment/VictimisationWhistleblowingHealth & SafetyAsserting a Statutory RightUnpaid wages/commission/bonus/holiday pay/notice payProtective award (failiure to collectively consult where when more than 20 employees are made redundant)Type of discrimination*There are only nine protected characteristics. Anything outside of these categories will not count as discrimination under the Equality Act 2010.Type of discriminationGenderGender ReassignmentRacialReligiousMarriage & Civil PartnershipAgeDisabilityPregnancy/MaternitySexual OrientationOtherHave you suffered harassment or victimisation?Have you suffered harassment or victimisation?HarassmentVictimisationBothNeitherHarassment is when someone behaves in a way which offends you or makes you feel distressed, degraded, humiliated or intimidated (eg sex or racial harassment). Victimisation is when an employer treats you badly because you have made a claim or a complaint about discrimination, ie retaliation for speaking out about discrimination in the work place.What is your disability?The definition of a Disability under the Equality Act 2010 is a physical or mental impairment that has a substantial and long term negative effect on your ability to do normal daily activities.Please state disability hereFor example: Long term depression, MS, Cancer, Blindness, Bipolar etc.Please describe how you were treated unfavourably because of your disability, including details failure to make reasonable adjustments.Broadly speaking, discrimination arises when you are treated unfavourably because of a protected characteristic. Please give concise details of the treatment you received, including dates.Describe BRIEF details of the protected disclosure/whistleblowing?About and to whom did you make the protected disclosure/blew the whistle. e.g. I work in a care home. On 25 March 2018, I emailed my line manager about a resident being neglected.Please describe brief details of the defamatory comment.Please include (1) the date(s) of the defamatory comment/s (2) who they were made to and (3) please obtain information as to ability of the opponent to pay damages and costs.Please describe brief details (additional - Client input)*What is your key date?*A key date is the date of the "thing" that you wish to make a claim about. For instance, date of dismissal, resignation, TUPE transfer, act of discrimination/victimisation or date of unlawful deduction from wages Please describe brief details (non-employment)?*Thanks for the information that you have provided so far, but in order to assess the case more efficiently, please provide us with a few more details about your case.Please also include details of key dates.Value of claimAre there any other aspects to your claim (please choose one)?*If there are more aspects to your claim, Please include details "Additional Information" at the end of the form.Are there any other aspects to your claim?No other aspectsOffered a settlement agreementDiscriminationWhistleblowingHealth & Safety DismissalAsserting a Statutory RightUnlawful deduction of wagesOtherAre you owed wages, holiday pay, bonus, commission etc?YesNoHow much are you owed?(£) Leave blank if unknown.Legal CostsIf we are unable to place your case on a no-win-no-fee basis, are you willing to contribute to legal costs?*We will make every attempt to place your case with a no-win-no-fee solicitor, however if your case is unsuitable for no-win-no-fee, are you able to contribute legal costs?YesNoMaybeDo you have legal expenses insurance?*YesNoMaybeHave you been offered a settlement agreement?*YesNoACAS/Tribunal InformationHave you submitted to ACAS yet?*YesNoHave you received your ACAS Certificate yet?*YesNoWhat is the date on the certificate?* Have you submitted an ET1 to the Tribunal yet?*YesNoFinancial InformationWhat do you get paid per year before tax (approx)? (£)*What do you get paid per year before tax (approx)? (£)0 - 10k10k - 15k15 - 20k20 - 30k30 - 40k40 - 50K50 - 70k70k +Additional InformationAdditional InformationConsentYour GDPR Consent* By ticking this box, you consent that you are happy for your personal details and case information to be passed to and used by Tom Street & Co. panel Lawyers/Barristers to assess and accept your potential claim. You also agree that you can be contacted by Tom Street & Co. and their panel Lawyers/Barristers.NameThis field is for validation purposes and should be left unchanged.