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Attorney Intake Form: Defamation or Slander

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If someone is painting you in a bad light in print or otherwise, you may have been defamed or slandered. These legal claims depend on specific facts to establish liability. This intake form can help you and your attorney determine whether the offending party has intruded on your legal rights. Keep in mind, though, that everyone has a free speech right, and that can extend to saying or publishing certain things, even if they are negative.

Name:

Address:



Home Telephone(s):
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Employer's Name:

Employer's Address:



Work Telephone(s):
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May we contact you at work? Yes _______    No _______

 

Why do you need legal advice about defamation?

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__________________________________________________________________________

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Section I: If You Think You Have Been Defamed, please answer the following questions.

Did the defamatory statement consist of specific words that were spoken or written?

Yes _______    No _______

 

Please provide a brief description of circumstances of the defamatory or slanderous statement and what was said or published.

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Did the defamatory or slanderous statement consist of some unspoken expression or act that implied something untrue or unsavory about you?

Yes _______    No _______

Please explain the circumstances and describe the defamatory or slanderous act.

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__________________________________________________________________________

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How long ago did the defamation or slander occur?

In the last year _______

More than one year ago _______

More than two years ago _______

More than three years ago _______

If you know the precise date, please write it here: _________________________________

Did the statement suggest any of the following? Check all that apply.

That you are

a criminal _______

a person of lax morals _______

a drunk or a drug abuser _______

an adulterer _______

an abuser of your spouse or children _______

an unfit parent _______

a liar _______

a thief _______

a cheat _______

Did the statement suggest that you

cheat on your taxes _______

run a shady business, or engage in sharp practices _______

sell adulterated food _______

sell pirated goods _______

cheat your customers _______

swindle elderly people _______

Where was the defamatory statement made?

At work in an open area _______

In a private meeting at work _______

In a performance review _______

At a meeting of your employer's executives _______

In a public place _______

At church _______

In your community _______

At a community meeting _______

Before the city council _______

Before legislators _______

In a communication to a governmental agency _______

In court _______

In a newspaper or magazine _______

In a book _______

Over the radio _______

On TV _______

On the Internet _______

How did you find out about the statement?

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Who heard or read or saw the defamatory statement? Please be specific.

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Was the defamatory statement directed toward your business?

Yes _______    No _______

Do you think that the defamatory statement could have had a negative impact on your business?

Yes _______    No _______

Section II: If you are being sued, please answer the following questions.

What was going on when the alleged defamatory statement was made? What were the circumstances?

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How long ago did the defamation occur?

In the last year _______

More than one year ago _______

More than two years ago _______

More than three years ago _______

If you know the precise date, please write it here: _________________________________

Who is the plaintiff and what does he or she do?

__________________________________________________________________________

__________________________________________________________________________

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Is the plaintiff a public official?

Yes _______    No _______

Is the plaintiff somebody well-known?

Yes _______    No _______

Where did the alleged defamatory statement take place? (Consult the list in Section I.).)

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Who else heard you make the alleged statement? Who read it? Who saw it?

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Was the statement true? Yes _______    No _______

If it was, please explain why you think it was true.

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Where did you get the information that formed the basis for the alleged defamatory statement?

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Did you confirm the information with third person?

Yes _______    No _______

Did you try to keep the information confidential if it was, in fact, given to you in confidence?

Yes _______    No _______

 

Does your liability insurance cover defamation?

Yes _______    No/Not Sure _______

No matter how you answer this question, have the policy, along with any amendments or riders to it, with you to the first meeting with your attorney.

Next Steps
Contact a qualified personal injury attorney to make sure
your rights are protected.
(e.g., Chicago, IL or 60611)

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