Intake Form

  • Client Intake Form
    The purpose of an initial consultation is for the Attorney to advise you, the prospective client on what if anything, may be done for you, and what the associated fees will be. The purpose is not to render a definitive legal opinion as it may be impossible to fully assess a matter within the time frame allotted for a consultation or with the (information or documents) that may be provided at the initial consultation


    One of three outcomes is possible following your consultation.

    A. You and the Attorney will mutually agree to the terms of representation, then a separate
    document called an Engagement letter is signed and a copy will be provided to you.

    B. The attorney declines representation.

    C. You decide not to use the services of the Attorney.


    NOTE: The following questions will help us to understand the reason for your visit today. Your responses are protected by attorney/client privilege and will be held in strict confidence.

    • Personal Information
    • Business Information
    • Reason for Contact
    • Terms and Conditions of your Employment
    • 0/100
    • 0/140
    • Previous Activity
    • Discrimination/Harassment
    • Damage/Injuries
    • Disclosure & Submission
    • PLEASE READ CAREFULLY and SIGN BELOW:

      Following your initial interview, if you agree to hire the attorney, and the Attorney agrees to represent you, you will both sign an Agreement for Representation. The Agreement for Representation will set forth the terms and conditions of representation. If the Attorney is willing to represent you and you decide not to sign an Agreement for Representation today, you are strongly urged to schedule the second appointment with the Attorney at the earliest possible or to immediately consult with other legal counsel to protect your rights.

      NOTICE: This office does not represent you with regard to the matters set forth by you herein in this information sheet or discussed during your consultation unless and until, both you and the Attorney execute a written Agreement for Representation. If the Attorney does not agree to represent you, this includes not representing you with regard to the matter set forth by you on this information sheet, nor any other matters you may discuss with the Attorney during your consultation. If your legal problem(s) involve a potential lawsuit, it is important that you realize a lawsuit must be filed within a certain period of time called Statute of Limitations. Therefore, the Attorney strongly urges you to immediately consult with another Attorney to protect your rights. The Attorney's decision not to repesent you should not be taken you as an expression regarding the merits of your case.

    • Your signature acknowledges only that "you" submitted a copy of this completed information sheet and does not mean you hired an Attorney.

    • Clear
    • Should be Empty: