Pre-Consultation Intake Form
About You
Name
*
First Name
Last Name
Age
*
Under 40
Age 40-50
Age 51-60
Age 61-70
Age 71-80
Age 80+
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Spouse's Name (if applicable)
First Name
Last Name
Spouse's Age (if applicable)
Under 40
Age 40-50
Age 51-60
Age 61-70
Age 71-80
Age 80+
Spouse's Email (if applicable)
example@example.com
Spouse's Phone Number (if applicable)
Please enter a valid phone number.
Format: (000) 000-0000.
Back
Next
Tell Us About Your Estate Planning Goals
Do You Have an Existing Estate Plan? (i.e., will, trust, power of attorney)
Yes
No
Unsure
What Are Your Estate Planning Priorities? Check All That Apply:
*
Avoid Probate
Minimize Taxes
Provide Financially for Family
Protect Child's Inheritance
Privacy in Settling My Estate
Ease of Administering My Estate
Charitable Contributions
Provide for Beneficiaries Outside of Family (i.e. friends)
Provide for a Child or Loved One with Special Needs
Protect Assets from Long-Term Care Costs
Keep Home or Land Within the Family
Business Succession
Pass home or real property to loved ones outside of probate
What Type of Assets Do You Own (check all that apply):
Bank Accounts (Checking, Savings, Money Market)
Brokerage Accounts (Stocks, Bonds, Mutual Funds)
Retirement Accounts (IRA, 401k, Roth Accounts, Retirement Annuities)
Crypto/Digital Currency
Other
Do You Own Any Valuable Collections? (i.e., coins, jewelry, memorabilia)
Yes
No
How did you hear about Ohio Heritage Law?
Google Search
Referred by friend/family
Social Media (Facebook, Instagram, etc.)
Referred by Professional (Financial Planner, CPA, Realtor, etc.)
Noticed Sign/Building Location
Speaking Engagement / Community Event
Other
Is there anything else that you want us to know? Please list and describe any specific concerns or circumstances that you want to address in your estate plan:
Submit
Should be Empty: