Brittany Pelletier Document Studio, LLC - Client Intake
Please complete this form to request document preparation, administrative support, or other services. We will review your submission and contact you with the next steps.
Client Information
Full Name
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Full Address
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Phone Number
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Email Address
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Service Request
Service Selection: Please select the service you are requesting (all fees based on Medicaid rate $49.28 per 15 minutes/ $197.12 per hour.
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Document Preparation (court filings, legal forms, contracts, motions, petitions, affidavits, etc.) - $49.28 per 15 min
Case Management & Advocacy (benefits navigation, housing support, Medicaid/Medicare assistance, SSDI/SSI help, discharge planning, etc.) - $49.28 Per 15 min
Certified Recovery Support Services (CRSW) - $49.28 per 15 min
Administrative Support (research, drafting correspondence, form completion, scanning/organizing documents) $49.28 Per 15 min
Consultation/Client Meetings (in person, phone, or virtual) - $49.28 per 15 min
Hourly Rate (4 units) -197.12
Half-Day Rate (16 units/4 Hours) - 789.00
Full-Day Rate (32 units/ 8 Hours) - $1578.00
Deadline for Completion
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Month
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Day
Year
Date
Brief Project or Document Description
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Important Notice
Brittany Pelletier Document Studio, LLC is not a law firm, and I am not an attorney. I do not provide legal advice or legal representation. All services are administrative, supportive, or advocacy-based in nature. You remain responsible for reviewing documents and seeking independent legal counsel as needed.
Acknowledgement & Agreement
Acknowledgment Checkbox
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I have selected the service(s) needed.
I understand fees are based on Medicaid rates.
I acknowledge that Brittany Pelletier Document Studio, LLC is not a law firm and does not provide legal advice.
I agree to pay for services according to the terms listed above.
Terms Checkbox
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I agree to the terms of service and payment requirements.
Signature
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