Thank you so much for contacting our law office! Please read the privacy policy below, and then fill out this form in its entirety prior to our consultation. Some of the questions, as you review them, may not be applicable to your case. For example, if we ask for your spouse's name and it is a paternity matter, please select or type in n/a as needed.

Privacy Policy

All information received from a client is strictly confidential. Our firm takes every step possible to protect your privacy. The data submitted via this form is encrypted and secured using industry-standard 256-bit SSL encryption.

Your Social Security Number and other personal information, such as your date of birth, will only be used in the event that you hire the firm to represent you in your legal matter, and then only when necessary in limited use during the course of your case.

Social Security Numbers are most often used to positively identify parties. Most courts require Social Security Numbers of all parties in a case. Some other examples of how this information may be used include:

initial service
in court orders
in required reports or other documents filed with the State

If you have any questions, please don't hesitate to contact our law office. We look forward to working with you!

Contact information: Contact 1

Prefix

First name *

Middle name

Last name *

Date of birth

Company

Emails

Address *

Type

Upon submission, a copy of this form will be sent to the primary email.

Add email

Addresses

Street address

Country

City

State/Region

Zip/Postal code

Address type

Add address

Phone numbers

Phone number

Type

Add phone number

Contact information: Opposing Party - please fill out as much information as you know

Prefix

First name *

Middle name

Last name *

Date of birth

Company

Emails

Address *

Type

Add email

Addresses

Street address

Country

City

State/Region

Zip/Postal code

Address type

Add address

Phone numbers

Phone number

Type

Add phone number

THANK YOU

Thank you so much for completing this intake questionnaire. This information will be extremely helpful in evaluating your case. We will contact you as soon as possible with any updates.

Please click the SUBMIT button below when you have finished answering all questions.

Contact information: Contact 1

Date of the Form

Preferred Contact Method

Gender

Social Security Number

Marital Status

Are you currently employed?

How were you referred to our law firm?

If our law firm ends up representing you in this matter, will you be the person who pays the legal fees?

Which of the below best summarizes your matter?

Who is the opposing party in your matter?

Contact information: Opposing Party - please fill out as much information as you know

Are you currently represented by another attorney?

Have you consulted with other attorneys on your matter?

Are children involved in this matter?

Is the opposing party represented by counsel?

What is your highest level of education?

What is the opposing party's highest level of education?

Does the opposing party have any lucidity issues?

Please, in your own words, explain your main goal that you hope to accomplish through this representation.

ACKNOWLEDGEMENT AND ACCEPTANCE

THANK YOU