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Intake Form Daniel Albert
Please filed Out the Intake form and complete the $85 payment to schedule your appointment with the attorney Daniel Albert.
Full Name
*
First Name
Last Name
Date of Birthday
*
-
Month
-
Day
Year
Date
E-mail
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employer & Job Title?
*
Explain in detail your situation
*
List Your Specific Questions for your attorney
*
Marital Status:
Single
Married
Separated
Divorced
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What legal action(s) were you involved in previously, if any?
Do you currently have a will?
*
Yes
No
Do you own your own home?
*
Yes
No
Do you own a business
*
Yes
No
Do you need a legal assistance for any immigration status?
*
Yes
No
Would you like a free consultation for your next visit ($85 value)?
*
Yes
No
Would you like to participate in our referral program (10% discount)?
*
Yes
No
Payment Options?
Credit card
Debit card
Paypal
How do you like to have the meeting?
Zoom (Video)
Phone Call
In Person
Signature
*
Important Note
Please bring all documents and be prepared with all your questions. This consultation is nonrefundable.
You'll receive an email notification for this Appoinment?
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30 Min Consultation
$
150.00
Appointment 30 Min
Payment Methods
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