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Case Evaluation

*Name:
*Address:
*City:
*State:
*Zip:

*E-mail address:

*Home Phone:
Business Phone:
Cellular or Pager:
Facsimile:
Are you known by any other names?
Yes No
If yes, list other names you have used:
What is your marital status?
Does this matter involve a business you own or run?
Yes No
If yes, provide the business name, address, and phone:
If a business is involved, how is the business organized (if known)?
Are you employed?
YesNo
If yes, please provide your job title and employer's name and address:
Can you be contacted at work?
Yes No
What area of law does your situation involve (if known)?
Describe your situation, including any relevant dates:
How would you rate your legal needs described here?
Are any other people involved?
YesNo
If yes, provide names, addresses (if known), and their relationship to you, if any:
Do you have any documents that could help explain your situation?
YesNo
If yes, list those documents and their dates:
Are there other documents that you do not have access to that could be of assistance?
YesNo
If yes, list those documents and their dates and location (if known):
Describe how this situation has impacted you:
Describe what you would like to happen to resolve your issue (your preferred outcome):
Have other attorneys worked on this matter?
YesNo
If yes, provide names, addresses, and a brief description of their involvement:
Special Concerns:
Where did you hear about this website?
 

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