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The document is a client intake form from Marie A. Mattox, P.A., a law firm in Tallahassee, Florida. It requests potential clients to provide detailed personal and employment information to evaluate their claims of discrimination or wrongful treatment. The form emphasizes confidentiality and the importance of thoroughness in responses, as well as instructions for submitting the completed form.

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Click ‘Get Form’ to open the marie maddox intake form in the editor.
Begin by filling out your basic information, including your name, race, date of birth, and social security number. Ensure accuracy as this information is crucial for your claim.
Provide your contact information. Include your current address, home phone number, cell phone number, and email address. This will help the firm reach you easily.
Complete the employment history section by listing your most recent employers. Be specific about dates of employment and reasons for leaving each position.
In the 'Information Regarding Your Claim' section, detail the individual or business involved in your claim. Specify the type of discrimination you believe occurred.
Describe the incident that led to your claim in detail. Use clear language to convey what happened and how it affected you.
Finally, review all sections for completeness and accuracy before submitting the form through our platform.

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