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Employer Self-Assessment (ESA) — Blank Specimen
For internal review, authorization, and offline preparation prior to completing the live ESA.
Download blank specimen (PDF)
Employer Intake — Core Hiring Information
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Firm / Organization
*
Help: Full legal name used in recruiting materials.
Website / URL
*
Source-of-truth reference
Name
*
Who we follow up with.
Position Title
*
Context for authority.
Primary Contact Company Email
*
Results posted to your Verolex account.
*
I’m authorized to share these materials
Hiring Scope (Next 6 - 12 months)
Antitrust
Appellate
Aviation
Banking & Finance
Bankruptcy & Restructuring
Capital Markets
Commercial Litigation
Construction
Corporate
Creditors’ Rights
Criminal Defense
Cybersecurity & Data Privacy
Education Law
Energy
Environmental
Family Law
Government & Public Policy
Healthcare
Immigration
Infrastructure
Insurance
Intellectual Property
International Law
Labor & Employment
Life Sciences
Maritime
Media & Entertainment
Mergers & Acquisitions
Natural Resources
Personal Injury
Private Equity
Products Liability
Real Estate
Regulatory
Reinsurance
Securities
Sports Law
Tax
Technology Transactions
Trade & Compliance
Transportation
Trusts & Estates
Venture Capital
White Collar Defense
Other
Other
Hiring Locations
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View Location List
Locations
New York, New York
Los Angeles, California
Chicago, Illinois
Houston, Texas
Phoenix, Arizona
Philadelphia, Pennsylvania
San Antonio, Texas
San Diego, California
Dallas, Texas
Jacksonville, Florida
Fort Worth, Texas
San Jose, California
Austin, Texas
Charlotte, North Carolina
Columbus, Ohio
Indianapolis, Indiana
San Francisco, California
Seattle, Washington
Denver, Colorado
Oklahoma City, Oklahoma
Nashville, Tennessee
Washington, D.C.
El Paso, Texas
Las Vegas, Nevada
Boston, Massachusetts
Detroit, Michigan
Louisville, Kentucky
Portland, Oregon
Memphis, Tennessee
Baltimore, Maryland
Milwaukee, Wisconsin
Albuquerque, New Mexico
Tucson, Arizona
Fresno, California
Sacramento, California
Atlanta, Georgia
Mesa, Arizona
Kansas City, Missouri
Raleigh, North Carolina
Colorado Springs, Colorado
Omaha, Nebraska
Miami, Florida
Virginia Beach, Virginia
Long Beach, California
Oakland, California
Minneapolis, Minnesota
Bakersfield, California
Tulsa, Oklahoma
Tampa, Florida
Arlington, Texas
Aurora, Colorado
Wichita, Kansas
Cleveland, Ohio
New Orleans, Louisiana
Henderson, Nevada
Honolulu, Hawaii
Anaheim, California
Orlando, Florida
Lexington, Kentucky
Stockton, California
Riverside, California
Irvine, California
Corpus Christi, Texas
Newark, New Jersey
Santa Ana, California
Cincinnati, Ohio
Pittsburgh, Pennsylvania
Saint Paul, Minnesota
Greensboro, North Carolina
Jersey City, New Jersey
Durham, North Carolina
Lincoln, Nebraska
North Las Vegas, Nevada
Plano, Texas
Anchorage, Alaska
Gilbert, Arizona
Madison, Wisconsin
Reno, Nevada
Chandler, Arizona
St. Louis, Missouri
Chula Vista, California
Buffalo, New York
Fort Wayne, Indiana
Lubbock, Texas
St. Petersburg, Florida
Toledo, Ohio
Laredo, Texas
Port St. Lucie, Florida
Glendale, Arizona
Irving, Texas
Winston-Salem, North Carolina
Chesapeake, Virginia
Garland, Texas
Scottsdale, Arizona
Boise, Idaho
Hialeah, Florida
Frisco, Texas
Richmond, Virginia
Cape Coral, Florida
Norfolk, Virginia
Tokyo — Tokyo Metropolis, Japan
Jakarta — Special Capital Region (DKI), Indonesia
Delhi — National Capital Territory, India
Manila — National Capital Region, Philippines
São Paulo — São Paulo, Brazil
Seoul–Incheon — Seoul & Incheon, South Korea
Mumbai — Maharashtra, India
Shanghai — Shanghai Municipality, China
Mexico City — Mexico City (CDMX), Mexico
Cairo — Cairo Governorate, Egypt
Beijing — Beijing Municipality, China
Guangzhou–Foshan — Guangdong, China
Dhaka — Dhaka Division, Bangladesh
Osaka–Kobe–Kyoto — Kansai (Osaka/Hyōgo/Kyoto), Japan
Shenzhen — Guangdong, China
Karachi — Sindh, Pakistan
Lagos — Lagos State, Nigeria
Istanbul — Istanbul Province, Turkey
Bangkok — Bangkok Metropolitan Region, Thailand
Kolkata — West Bengal, India
Other
Other
Work Model
On-site
Hybrid
Remote
Mixed by team
Other
Other
Jurisdiction
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio; Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina;
Choice 38
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Northern Mariana Islands
Puerto Rico
U.S. Virgin Islands.
Other
Other
Conflicts Check
Former clients
Adverse matters
Side practice
Investments
Other
Other
Billiable Expectation
If Floor
If Target
If Range
Not applicable (in-house/public)
Minimum annual billable hours → Number
for Number
Annual billable hours target → Number
Annual hours (low end) → Number
Annual hours (high end) → Number
Annual hours (high end) → Number
Scores (0–100)
Materials completeness — Number (Required; min 0, max 100, step 1)
Policy clarity — Number (Required; 0–100)
Role architecture — Number (Required; 0–100)
Compliance guardrails — Number (Required; 0–100)
Data governance — Number (Required; 0–100)
Critical flags (must be zero for Go/Scoped)
EEO-risk language
Missing conflicts / eligibility
PII exposure
Contradictory policies
Scope tags
benefits
eligibility
conflicts
work_model
compensation
screening_flow
Notes • Reviewer notes
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