Client Intake Sheet

Please complete the following form to send us information so we can generate our engagement letter for you:

Your Personal Name (required)
Is our client here an entity? YesNo
(if so please complete the next line)
Entity name
(only applicable if you are submitting for an entity as the client)
Your address (1st line)
(please, no P.O. Boxes)
Your address (2nd line)
(optional)
City, State and Zip Code
(required)
(international users please approximate this information)
Phone numbers
(main is required)

Main:

Cell:

Fax:

Adverse parties?
(please identify parties adverse to you in this representation, if applicable)
Were you referred to us?
(if so please identify the referring party)
Related parties?
(if there are entities or persons related to you, please include so we can check conflicts)
Web site:
(optional)
Your Email address (required)
Give a very brief description of your inquiry subject matter
Please confirm you are an individual

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