Confidential Intake Form
Please complete the following, confidential intake forms before your scheduled appointment. Please feel out in as much detail as possible. This form should take approximately fifteen (15) minutes to complete.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date and Time of Consultation with Carlson & Work
If you have scheduled a consult with Carlson & Work, please provide the date and time of your consult. If you have yet to schedule a consult, please provide an available date and time.
Your Employer & Income
*
Name of Opposing Party/Spouse
First Name
Last Name
Opposing Party/Spouse's Employer & Income
Are you looking for representation in an existing case?
Yes
No
Case Number
Detailed summary of legal matter
Legal Matter
*
Family
Divorce
Custody
TPO
Estate
Defense
Children's Name(s) & Date(s) of Birth
If applicable, please provide children's names and dates of birth.
Next Court Date & Time
Please include date, time and location. If there is no scheduled court date please indicate below.
Debts & Assets
If applicable, please provide a list of debts and assets and how you wish the court to divide.
Length of Marriage: If Applicable
Would You Like Family Estate Planning?
*
Yes
No
Do you have an up to date family estate in place?
Yes
No
Would you like Carlson & Work to generate family estate documents?
Yes
No
How did you hear about us?
*
Google
Yelp
Facebook
Attorney Referral
Personal Referral
Avvo
Other
By checking this box, I consent to the consultation fee due on date of consult.
*
Consent
Reschedule Consultation
Please Initial to Approve Confidential Attorney Review
*
Please verify that you are human
*
Submit
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