This form is for people who previously submitted consent forms to join the lawsuit Peck v. Mercy Health, et al., Case No. 4:21-cv-00834-AGF, in the U.S. District Court for the Eastern District of Missouri. The Court granted Mercy's motion to decertify the FLSA collective action on April 21, 2026. As a result, the opt-in plaintiffs' claims were dismissed without prejudice, while Danielle Peck's individual claims remain pending. The Court also tolled the FLSA statute of limitations for opt-in plaintiffs for 60 days from April 21, 2026. Brown, LLC is reviewing whether to offer individual contingency-fee representation to certain former opt-in plaintiffs. Completing this form does not create an attorney-client relationship; representation begins only if both you and Brown, LLC sign a written agreement.

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If you know it, what date did you submit your consent form?

Given that you previously joined the lawsuit, Brown, LLC likely already has information for you, but please provide any updated contact information below.

Even if you do not recall whether you joined the lawsuit, please provide your contact information below so Brown, LLC can check its records.

Full Legal Name(Required)

Any different names used while working for Mercy?

Email address(Required)

Phone number(Required)

Employee ID, if known

When did you start working for Mercy in an hourly-paid, non-exempt position?

When did you last work for Mercy in an hourly-paid, non-exempt position? If you still do, write "current."

What job position(s) did you hold during that time?

What Mercy facility or facilities did you work at during that time?

What city and state was each Mercy facility located in?

Thank you. Brown, LLC will review the information you submitted, along with available case records. Brown, LLC does not represent you in an individual lawsuit unless Brown, LLC offers you a retainer agreement and both you and Brown, LLC sign it. If you are interested in following up, please email Brown, LLC's FLSA Group at mercycase@jtblawgroup.com.

What an individual lawsuit may involve: if you file your own lawsuit, your name would likely appear in the case caption; you may need to sit for a deposition, search for and produce relevant documents, answer written questions, and potentially testify at trial in St. Louis, Missouri.

Thank you. Brown, LLC will review the information you submitted, along with available case records. Brown, LLC does not represent you in an individual lawsuit unless Brown, LLC offers you a retainer agreement and both you and Brown, LLC sign it. If you are interested in following up, please email Brown, LLC's FLSA Group at mercycase@jtblawgroup.com.

Please answer the following confidential questions for your work with Mercy from June 2019 to the present. Where possible, identify witnesses by name and identify any supporting documents that you or Mercy may have.

Please identify by name each leader, supervisor, manager, charge nurse, or other Mercy representative who knew about your missed meal breaks, your automatic meal deductions, or both. If you do not know a person’s full name, provide as much identifying information as you can.

Estimate the number of shifts in which one or more leaders, supervisors, managers, charge nurses, or other Mercy representatives knew both that: (1) you did not receive a 30-minute meal break spent predominantly for your own benefit; and (2) a 30-minute meal deduction was still applied to your pay.

For those shifts, explain why you did not receive a 30-minute meal break spent predominantly for your own benefit, and how each leader, supervisor, manager, charge nurse, or other Mercy representative you identified knew this.

For those shifts, explain why the 30-minute meal deduction was not cancelled through Kronos or an exception form, and how each leader, supervisor, manager, charge nurse, or other Mercy representative you identified knew the deduction was not cancelled.

Identify any documents, texts, emails, schedules, pay records, policies, or witness names that support your meal-break claim.

Please provide any other facts that make your Mercy unpaid-meal-break claim particularly strong, including work tenure, hours worked, how often and why meal breaks were missed, whether the deduction was cancelled, and evidence of Mercy's knowledge.

Is there an amount you would be willing to accept to settle your claim for unpaid wages based on missed meal deductions? If yes, state the dollar amount. If no, write "no amount at this time."

Please summarize your additional or different potential claims against Mercy.

Brown, LLC may decide not to offer representation on additional or different claims after review.

What is the name of that employer?

What were your dates of employment with that employer?

What city and state were you located in when working for that employer?

Please summarize your potential wage-and-hour claim against that employer.

Comments on your experience with Brown, LLC or anything else you want us to know.

Thank you. Brown, LLC will review the information you submitted, along with available case records. Brown, LLC does not represent you in an individual lawsuit unless Brown, LLC offers you a retainer agreement and both you and Brown, LLC sign it. If you are interested in following up, please email Brown, LLC's FLSA Group at mercycase@jtblawgroup.com.

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