CLIENT INFORMATION FORM

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PLEASE READ CAREFULLY and SIGN BELOW

Following your initial interview, if you agree to hire the Attorney, and the Attorney agrees to represent you, you will both sign a Retainer Agreement. The Retainer Agreement will set forth all the terms and the conditions of representation. If the Attorney is willing to represent you and you decide not to sign a Retainer Agreement for representation today, you are strongly urged to schedule a second appointment with the Attorney at the earliest possible time or to immediately consult with other legal counsel to protect your rights.
NOTICE: This office does not represent you with regard to the matter set forth by you herein in this information sheet or discussed during your consultation, unless and until both you and the Attorney execute a written Retainer Agreement.
If the Attorney does not agree to represent you, this includes not representing you with regard to the matter set forth by you on this information sheet, it means you have not hired the Attorney.
Date

MonthDayYear
Date

This Portion to be completed by the Attorney
Type a question

Will representWill investigate and reportRepresentation declinedParty will think about it and get back with us - No action to be taken and party was so informed.Client declined representation at this time
Interviewed by blanks this blankof      Month   in the year   Year
Retainer Fee Quoted   Fee
Terms:   Term
Term
  Term
  Term
Office Use Only
Area/ Jurisdiction (Civil,Crim etc)
Case Number
Court and Magistrate/ Judge
Opposing Counsel Information
Name(s)
Chambers/ Firm
Mailing Address
Contact Nos.
Email Address
Additional Notes
Should be Empty:

Employment Information