Mercer County Schools Harassment Victim Intake Form | Submit Your Details Today — J Brown Law Group PLLC

Mercer County Schools

Harassment Victim

Intake Form

A young girl with a closed mouth, hair tied back, and a black tape over her mouth with a sign that says 'HELP'. The image is part of an advocacy flyer about addressing harassment and abuse by school staff in Mercer County, West Virginia, encouraging victims to seek legal help and report experiences.

Name

First Name

Last Name

Phone

(###)

###

####

Email

Age

If submitter is under the age of 18, please have a parent or guardian provide their contact information.

Relationship to Victim

Message

In addition to texting or calling, you may also fill out our intake form and someone from our staff will contact you to schedule your free consultation.