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 Identification Number and other 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.

Identification Numbers are most often used to positively identify parties.

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

Contact information: Client Information

Prefix

First name *

Middle name

Last name *

Date of birth

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

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Phone numbers

Phone number

Type

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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.

Date

Contact information: Client Information

Preferred Contact Method

Gender

Identification Number

Type of Matter

Employment Status

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?

Emergency Contact

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

THANK YOU