NHCO Ask the Attorney Consultation Request Form

NHCO Ask the Attorney Consultation Request Form

Hello and thanks for your interest in North Hills Community Outreach's (NHCO) Ask the Attorney (ATA) program. ATA offers free, 30 minute legal consultations to people who live in our service area (Northern Allegheny County outside of the City of Pittsburgh) and income qualify (250% of the Federal Poverty level). This program is set up to offer advice and direction on all legal matters except for those of a criminal nature. *The program is not set up for attorneys to make calls or write letters on your behalf or to represent you in court.* We host in person ATA sessions on the third Tuesday of the month rotating between our Millvale, North Boroughs and Allison Park offices. We are taking the month of December 2022 off and will resume in person appointments starting on January 17, 2023. Please answer the questions below to the best of your ability and someone will follow up with you as soon as possible.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
**IMPORTANT** Some of our attorneys and volunteers will not leave a voicemail unless they have permission when trying to contact you for confidentiality purposes. Please answer the following question:*

It is OK to leave me a voicemail.It is NOT OK to leave me a voicemail.
Email
example@example.com
Date of Birth *

MonthDayYear
Date
How many people live in your household?*
Please provide us with your Gross Yearly Household Income (this includes yourself and anyone else living with you):*
Are you a Veteran?*

YesNo
Please provide a description of your legal issue:*
What are your specific questions for the attorney?
If there are any deadlines related to your case, list them here:
Please list the names of all parties involved in this dispute:
Please give the name(s) of any attorneys consulted on this matter to date:
Please list any other actions you have taken related to this matter to date:
All appointments are scheduled between the hours of 5:30pm - 8pm depending on volunteer attorney available on the third Tuesday of the month rotating between our Allison Park, North Boroughs, and Millvale offices, unless otherwise noted. Someone will contact you to schedule a time.*

I would like to schedule at Allison ParkI would like to schedule at North BoroughI would like to schedule at MillvaleI would like to schedule the first available appointment
Limited Consultation Agreement

For North Hills Community Outreach

Ask the Attorney Program

(**signature required**)

I understand that I am meeting with a Volunteer Attorney through the North Hills Community Outreach (NHCO) Ask the Attorney program on a pro bono basis for a 30 minute consultation. I understand that said attorney has agreed to meet with me at my 30 minute consultation only. I understand that this Attorney has no obligation to represent me in any other matter.
Signature*

Clear
*Please use your mouse (or mouse pad) on a computer and your finger on a smart phone to sign this form.
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