See if You Qualify for Compensation

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• Which Rideshare Service?*
  UberLyftOther
• Which state did the ride take place in?*
  Select OneALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPAPRRISCSDTNTXUTVTVAWAWVWIWY
• Were you Physically Assaulted (sexual in nature) while in a Rideshare?*
  Select OneYesNo
• By clicking the “SEE IF I QUALIFY” button above, I expressly consent to receive autodialed phone calls, emails, and text from The Sentinel Group Law or its partners at the cell phone number provided above. I acknowledge that I am not required to consent to receiving such calls emails, and text as a condition of purchasing or using any services.

• Which of the following occurred?*
  Select OneInappropriate TouchingPenetrationExposure of genitalsMasturbationKissingFondlingOral SexSexual IntercourseVerbal AssaultPhysical AssaultNone of the above
• Do you have proof of when your ride happened (App or email receipt)?*
  Select OneYesNo
• Are you or a loved one currently working with an attorney?*
  Select OneYesNo
• By clicking the “SEE IF I QUALIFY” button above, I expressly consent to receive autodialed phone calls, emails, and text from The Sentinel Group Law or its partners at the cell phone number provided above. I acknowledge that I am not required to consent to receiving such calls emails, and text as a condition of purchasing or using any services.

• Name*
• Phone*
• What's your email address?*
• By clicking the “SEE IF I QUALIFY” button above, I expressly consent to receive autodialed phone calls, emails, and text from The Sentinel Group Law or its partners at the cell phone number provided above. I acknowledge that I am not required to consent to receiving such calls emails, and text as a condition of purchasing or using any services.

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• Phone
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