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

Should it read all information received from a potential client is strictly confidential.

Our firm takes every step possible to protect your privacy.

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

Social Security Numbers are most often used to positively identify parties. Most courts require Social Security Numbers of all parties in a matter(s). 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

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First name *

Middle name

Last name *

Date of birth

Company

Emails

Email Address *

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

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Addresses

Street address

Country

City

State/Region

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Phone numbers

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THANK YOU

Thank you so much for completing this intake questionnaire. This information will be extremely helpful in evaluating your matter(s). 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

Mailing Address (*if different)

Preferred Contact Method

Date of Birth

Gender

Social Security Number

Driver's License 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?

ACKNOWLEDGEMENT AND ACCEPTANCE

THANK YOU