General Intake Form

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.

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 personal information 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

Prefix

First name *

Middle name

Last name *

Email *

Phone number

Street address

City

State/Province

Zip/Postal code

Personal Details

Preferred Contact Method

Gender

Social Security Number

Driver's License / Government ID (Please attach document) *

Marital Status

Are you currently employed?

Yes No

Legal Matter & Acknowledgment

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?

Yes No

What type of matter do you need assistance with?

If you selected “Other,” please describe the type of legal assistance you need. If you are selling or buying a property please include the address.

Acknowledgment

Please acknowledge that you have read and hereby accept the above privacy policy regarding use of my personal information by typing your full legal name below: