Client Intake Form (General)

Client Intake Form (General)
Full Name:*

First NameMiddle NameLast Name
Company Name (if applicable):

Street Address Line 2

CityState / Province

Postal / Zip Code
Full Contact name (if business):

First NameLast Name
Mailing Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Address (if different):

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth

MonthDayYear
Date
Name of Employer:
Occupation:
Address of Employer:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone: *
Please enter a valid phone number.
Phone Number*
Please enter any other valid phone number
Email:*
example@example.com
Please provide a brief description of your matter:
Names of opposing parties:
*If your matter is a property dispute, please list the address of the other party as well as the owner’s full name(s). *If your matter is related to a strata, please note the name of the strata in full.
The Law Society of British Columbia requires lawyers to follow client identification and verification procedures when providing legal services.
Please attach copies of two different pieces of ID, one must be government issued photo ID:**

Drivers LicenseOther Provincial Photo IDPassportOther Federal Photo IDOther Government issued ID without photos (Birth Certificate, Health Insurance Card, etc.)
Upload ID:*

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Please also attach any relevant documentation regarding your legal matter.
Upload supporting documents:

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How did you hear about us ?

Social MediaSearch engine (Google, Yahoo, etc.)Online Blog/ PublicationReferred by:Other
Name Of The Referred Person:
A-45515 Knight Road, Chilliwack, B.C. V2R 5L2 (Chilliwack office)
317 – 9440 202nd Street, Langley, B.C. V1M 4A6 (Langley office)
Phone: 604-705-0022 / Fax: 604-705-0033
www.sorensensmith.com
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