Family Court Intake Form

Family Court Intake Form

Family Court Intake Form

Family Court
Petitioner ( Your name)*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Date of Birth

MonthDayYear
Date
Petitioner Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Defendant (The Other Party)*

First NameLast Name
Defendant Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Which do you feel would be describe your case need:*

Self-Representation with GuidanceHiring an Attorney
Brief Description of the Legal Issue (Please be very detailed):*
Type of Legal Matter

Family LawEmploymentPersonal InjuryEstate PlanningCivil LitigationOther
Date the Issue Occurred:
Scheduled Court Appearance Date

MonthDayYear
Date
Is there a current court order in place for custody?

YesNo
CHILD INFORMATION

CHILD'S FIRST AND LAST NAMECHILD'S DATE OF BIRTH
CHILD INFORMATION

CHILD'S FIRST AND LAST NAMECHILD'S DATE OF BIRTH
CHILD INFORMATION

CHILD'S FIRST AND LAST NAMECHILD'S DATE OF BIRTH
CHILD INFORMATION

CHILD'S FIRST AND LAST NAMECHILD'S DATE OF BIRTH
CHILD INFORMATION

CHILD'S FIRST AND LAST NAMECHILD'S DATE OF BIRTH
CHILD'S ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Currently, the minor child(ren) reside with:
How long has the child(ren) lived at this address?
Petitioner requests that the parties be awarded joint custody

YesNo
Who does the Petitioner request to be designated as domiciliary parent
The term "domiciliary parent" refers to the parent who has primary physical custody of the children and with whom the children primarily reside. This parent is typically responsible for the day-to-day decisions regarding the children’s welfare and their primary residence.
Who does the Petitioner request to be designated as co-domiciliary parent
A "co-domiciliary parent" is a parent who shares custody of the children with the domiciliary parent but does not have primary physical custody. The co-domiciliary parent typically has visitation rights and participates in major decisions concerning the children but does not have the same day-to-day responsibilities as the domiciliary parent.
Petitioner requests that the parties be awarded joint custody with the parties sharing equal time with the minor child(ren)

YesNo
Petitioner requests that Petitioner be awarded sole custody subject to one of thefollowing by the Respondent:

Petitioner requests that the Respondent be awarded reasonable visitationPetitioner requests that the Respondent be awarded supervised visitationPetitioner requests that the Respondent be not be awarded any visitation.
Please provide details about your shared time and visitation request:
Do you have any relevant documents or evidence related to your case (e.g., contracts, correspondence, medical records)? If yes, please upload any documents to support your case filing. If you are a Pro Se client and have an exhibit binder, you won't need to upload.

YesNo
File Upload

Cancelof
Petitioner believes the custody arrangement he/she is requesting is in the best interestof the child(ren) for the following reasons:
Non-Attorney Legal Services Agreement

This Non-Attorney Legal Services Agreement (the “Agreement”) is made and entered into as of the date this form is e-signed, by and between Midwest Legal Solutions LLC (hereinafter “Midwest Legal Solutions”) and the Client listed within this e-form (hereinafter “Client”).

Recitals
The client needs non-attorney legal services.
Midwest Legal Solutions provides non-attorney legal assistance to individuals and entities.
The parties wish to set forth the terms of their engagement in writing.

Scope of Services
Midwest Legal Solutions agrees to perform the following services for the Client:

Drafting legal documents and correspondence
Conducting legal research
Managing case files and documentation
Assisting in preparation for trials, hearings, and meetings
Other tasks as required, provided they are within the scope of permissible non-attorney services

Hourly Rate: $65/hour

Hourly services include:

Legal research and analysis
Document preparation and filing (pleadings, motions, etc.)
Litigation support (case prep, trial assistance, post-trial motions)
Client and witness interviews
Trial preparation and proceedings (evidence organization, exhibit prep, hearing support)
Calendar and deadline management
General administrative support (filing, data entry, clerical tasks)

Flat Rate Services:

Business Management $50-$1100
Standard Power of Attorney (new or revised) $75 – $175
Simple Will Preparation $200
Lease Agreement Preparation $100-250
General Contracts $250-$500
Legal Document Review $100 – $200
Legal Document Preparation (Amendments) $150 – $550
Legal Memorandum Drafting $300
Small Business Formation $350-$1200
Uncontested Divorce Filing $500
Standard Civil Lawsuits (non-family court) $350
Rush Service Fee +$50

Travel Fee (Local Only): $35

Fees do not include court costs, filing fees, notarization, or other third-party expenses.

Notes:

Flat-rate services include consultation, drafting, and finalization of documents.
Rush service applies to expedited requests.
Hourly services are billed in 15-minute increments.

Payment Terms
Payment is due upon receipt of the invoice.
No services will begin without payment of a $150 deposit or full payment.
Rates may change with prior notice; additional charges may apply for work beyond flat-rate services.
Non-payment may result in collection actions.

Refund Policy
All fees are non-refundable. Payment secures the time and services provided by Midwest Legal Solutions.

Client Responsibilities
The client is responsible for tracking court dates and attending all hearings.
Midwest Legal Solutions provides guidance, but the Client must verify schedules through official sources.

Electronic Communication
The Client agrees to accept electronic correspondence as the primary communication method.

No Guarantees
Midwest Legal Solutions does not guarantee specific outcomes. Services are based on information provided by the Client. Any misrepresentation may affect effectiveness.

Non-Attorney Status & Disclaimer
Midwest Legal Solutions is not a law firm and does not provide legal advice or representation.
Services are limited to administrative, support, and non-attorney legal tasks.
No attorney-client relationship is created by this Agreement.
Clients are encouraged to seek licensed attorneys for legal advice or representation.

Modifications & Termination
This Agreement may be modified only in writing, signed by both parties.
Either party may terminate at any time with written notice; termination does not affect obligations incurred before termination.

Severability
If any provision is deemed invalid or unenforceable, the remainder of the Agreement remains in effect.

**Acknowledgment & Understanding**

By signing this Agreement, the Client confirms the following:

They understand that Midwest Legal Solutions provides non-attorney services only.
They acknowledge responsibility for any court appearances and legal matters.
They have read this entire Non-Attorney Legal Services Agreement and fully understand its terms.
They have had the opportunity to consult with a licensed attorney if they desired.

Agreement is effective upon signature.

Client Signature: _________________________ Date: ___________
Midwest Legal Solutions Representative: ___________________ Date: ___________
Signature*

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Date signed by Client*

MonthDayYear
Date
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