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Civil Rights Case Evaluation

Civil Rights Case Evaluation

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Name*
Address

We encourage you to complete this form in its entirety. The information we request is essential to us being able to evaluate whether or not you have a viable civil rights claim. Viable claims may not be identified if we do not have all the relevant information to assess your potential claim.

If after going through this form you require assistance in completing the Civil Rights Case Evaluation please call (303) 409-7556 and one of our intake specialists can assist you complete this form over the phone.

Civil Rights Violation

Did the incident giving rise to your potential civil rights claim occur within the last two years from the date of the incident?
Street (answer this question if known)
What type of potential civil rights claim do you believe you suffered? (select all that are applicable)
Max. file size: 512 MB.
*Video evidence is often critical in proving civil rights violations. Often times video will exist because police officers where body worn cameras. Governmental or private surveillance and security cameras can capture incidents too. The police department involved your potential civil rights violation will also likely have police and incident reports documenting the incident. This evidence is essential for Rights & Liberties Law Firm to evaluate your claim. We can assist you obtain this evidence if necessary. However, if you already have it, it will expedite our case evaluation process.

Injuries & Damages

Did you suffer any physical injuries?
Were you treated by a medical provider for any of the physical injuries you suffered?
Do you have the medical records documenting your physical injuries?*
If no please contact your medical provider to obtain those medical records. We are able to proceed with your case evaluation without medical records. However, obtaining the medical records related to the injuries you suffered as a result of a civil rights violation will be necessary to prove physical damages in your case. We can assist you in obtaining all the documentation you will need to prove your case. However, the sooner we have access to your medical records related to the potential civil rights claim, the sooner we can assess provable damages in your case.
Did you suffer any mental or emotional injuries?
Were you treated by a mental health provider for any of the mental or emotional injuries you suffered?
Do you have the mental health records documenting your mental or emotional injuries?*
If no please contact your mental health provider to obtain those records. We are able to proceed with your case evaluation without mental health records. However, obtaining the medical records related to the mental or emotional injuries you suffered as a result of a civil rights violation will be necessary to prove mental and emotional pain and suffering in your case. We can assist you in obtaining all the documentation you will need to prove your case. The sooner we have access to the records documenting mental or emotional injuries stemming from your potential civil rights claim, the sooner we can assess provable damages in your case.
Do you have the mental health records documenting your mental or emotional injuries?*
*Lost wages refer to the compensation awarded to a plaintiff to replace income they would have earned if not for the wrongful conduct that led to their injury or damages.
Did you lose employment or employment opportunities as a result of the incident giving rise to your potential civil rights claim?*
Lost employment refers to the compensation awarded to a plaintiff to replace income they would have earned if not for the wrongful conduct that led to their injury or damages. It encompasses the wages, salary, bonuses, commissions, and other benefits that the plaintiff would have received had they not suffered harm due to the defendant’s actions. Essentially, it compensates for the financial impact caused by the loss of employment opportunities.
Do you have documentation to support your lost wages or lost employment claims?
Consent*
Consent*
Consent
  • (303) 409-7556
  • cameron@rightsandlibertieslawfirm.com
  • 2840 Fairfax Street Denver, CO 80207 Suite 214
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