1. Instructions

    1. Instructions

  2. Personal Information

    1. *Please provide your full name.

    2. *Please provide your date of birth

    3. Please indicate your gender.

    4. *Please provide your primary contact phone number.

    5. *Please provide your primary contact email address.

    6. *Please provide your full address and postal/zip code.

    7. Please provide your social security number.

  3. Availability

    1. *What time of day do you prefer us to call?

    2. *May we communicate with you via text?

    3. *May we communicate with you by email?

    4. *Please check all that apply to you.

  4. Employment Details

    1. *What is your place of employment?

    2. *What is your current job title?

    3. *Please provide the address of your place of employment.

    4. What is your annual salary?

  5. Spouse's Details

    1. Please provide your spouse's full name.

    2. Please provide their current address.

    3. Please provide the name of your spouse's employer.

  6. Required Legal Representation

    1. *Please indicate the nature of the legal representation you require.

    2. *What are you hoping to achieve from legal representation?

    3. *Are you currently being represented by a different attorney for any separate legal issues?

    4. If so, what are your reasons behind seeking additional legal council?

  7. If you were referred by someone, please indicate their name here if desired.

    1. If you were referred by someone, please indicate their name here if desired.

    2. Is there anything else you'd like to add?

Law Firm Client Intake Form


Law Firm Client Intake Form

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*Please provide your full name.

*Please provide your date of birth

Please indicate your gender.

*Please provide your primary contact phone number.

*Please provide your full address and postal/zip code.

Please provide your social security number.

*What time of day do you prefer us to call?

*May we communicate with you via text?

  • Yes

  • No

*May we communicate with you by email?

  • Yes

  • No

*Please check all that apply to you.

  • I authorize emails concerning my case

  • I authorize emails of general interest from (INSERT COMPANY NAME HERE)

  • I authorize text messages concerning my case

  • I do not authorize electronic communication

*What is your place of employment?

*What is your current job title?

*Please provide the address of your place of employment.

What is your annual salary?

Please provide your spouse's full name.

Please provide their current address.

Please provide the name of your spouse's employer.

*Please indicate the nature of the legal representation you require.

  • Criminal

  • Child Support

  • Divorce

  • Guardianship

  • Personal Injury

  • Will/Trust

  • Contract Review or Formation

  • Contract Dispute

  • Debt Collection

  • Debt Collection Defence

  • Traffic

  • Expungements

  • Prenuptial Agreement

*What are you hoping to achieve from legal representation?

*Are you currently being represented by a different attorney for any separate legal issues?

If so, what are your reasons behind seeking additional legal council?

If you were referred by someone, please indicate their name here if desired.

Is there anything else you'd like to add?