Our Office 142 High Street, Holywood, BT18 9HS Tel: 028 9039 7771 Email: email@example.com Contact Us For A Free Initial Consultation Enquiry Form Dear Sir / Madam Thank you for making an enquiry. In order to assist us to provide you with advice, we would ask you to complete the form below so that we may learn more about your issue. This will then be submitted to Sheena Murphy who will review it and contact you to discuss the matter. NB – Please ensure that if possible you send an email from a private email address rather than a work email address in order to avoid your employer or colleagues having access to any potentially privileged or sensitive information. Full Name (required) Email Address (required) Telephone Number (required) Home Address Name of Your Employer Details of your Role Date of Commencement of Employment Date of Termination of Employment (If relevant) Please provide a summary of the issues you have been experiencing during the course of your employment – providing these in a sequence is preferable. Have you lodged any grievances or attended meetings with your Employer? Do you have an insurance policy which covers legal covers to take Tribunal proceedings and if so please furnish details. Yes / No How did you hear about Murphys Solicitors? We wish to advise you that there are very strict time limits for the lodgement of proceedings in employment law matters. Proceedings generally must be issued within 3 months of a dismissal or other act and it is therefore imperative that you complete the attached form as a matter of urgency and submit it to us. This form is simply the provision of information forming the basis of your enquiry – it does not amount to you instructing our firm. We will respond to your query as soon as possible. We wish to advise you that we will not be taking steps to protect your position until you have completed and accepted our terms and conditions of engagement. We wish to assure you that your personal data will be treated with sensitivity and confidentiality and you may request that this be removed from our database at any time.