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QUICK CLAIM
Issues with: employer pay, funds from government programs, or similar
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Your name (as is you're a plaintiff)
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First
Last
Unless you are completing this form for someone else, you are known as the plaintiff.
Your email
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This claim is against the following defendant(s):
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include the name(s), with email address(s), phone number(s), and website(s)
On a scale from one (1) to five (5), with 5 being the highest, what would you rate this individual/organization in terms of overall satisfaction?
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1 star rating (lowest / least satisfaction)
2
3
4
5 star rating (highest / most satisfaction)
Claim summary
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organized and easy-to-understand claims are facilitated the quickets
Desired outcome
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If the defendant fails to attempt to mediate, do you anticipate posting a low star rating and potentially derogatory comments to the publicly accessible major databases (i.e., Google, Bing, Yelp, BBB, Facebook, Twitter, etc.) which could negatively affect the defendant?
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Yes
No
Maybe
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