Whistleblower Questionnaire

If you would like an attorney from The Chanler Group to evaluate your case on a privileged and strictly confidential basis for potential representation in a False Claims Act lawsuit, please provide the information requested below. In completing this questionnaire, be as detailed as possible, and attach any supporting documents. It is important that you provide information in writing so that our attorneys may properly assess the merits of your case.

After you complete the questionnaire, you may click the submit button, which will transmit your information through The Chanler Group’s encrypted electronic mail system.  We at The Chanler Group understand the sensitivity of the situation created for you in coming forward.  Because of this, our primary concern is to protect your confidentiality and the confidentiality of the information you provide.  If you are especially concerned about protecting your identity and information, please contact us directly.

Terms and Conditions

Please be advised that the statute of limitations may be as short as six years for some claims under the False Claims Act.  Your ability to bring a false claims action may be eliminated if someone else publicly discloses the same illegal conduct, files a false claims action regarding the same conduct, or causes the government to take action on the conduct before you file an action.  If you become aware of any developments likely to go public that affect your claim, please contact us as soon as possible.

Please further be advised that you are responsible for keeping information about your claim confidential.  Do not post any details or even references to your claim on any blog, online discussion forum, or any social networks such as Facebook or Twitter.  Mentioning your claim on the Internet or in any other public forum may be detrimental to your claim.

Your communications with The Chanler Group, beginning with this questionnaire, are treated as privileged and confidential, although a formal attorney-client relationship will not automatically be created by submitting your information to The Chanler Group.

I agree that the questionnaire below does not constitute a request for legal advice and that I am not forming an attorney-client relationship by submitting this information. I understand that I may only retain an attorney by signing a written agreement, and that I am not hereby entering into a written agreement. I agree that any information that I will receive in response to the questionnaire is general information and I will not be charged for an initial response to this submission. I further understand that the law for each state may vary, and therefore, I will not rely upon this information as legal advice. Since this matter may require advice regarding my home state, I agree that local counsel may be contacted, with my permission, for referral of this matter.

If you agree, click "Submit Form". Otherwise, click "Cancel".