KD Estate Planning Intake Form

Thank you for your interest in Kirker Davis Estate Planning services. To help us better serve you, please provide the following information, select a package, then we will review the information and follow up with you.

We provide:

- Basic estate plan packages for a flat fee that include an attorney consultation

- In-office notarization if requested

- Legal services only in Texas

We do *not* provide:

- Probate services, complex trusts, or tax services

- multi-person representation

- “mirror”, “joint”, or “married couple” wills, because they can be problematic. If requested, we can provide referrals to other law firms for your spouse

Information About Person Needing Estate Planning Services

Name

First NameMiddle NameLast Name

Email

example@example.com

OK to send emails, bills, and confidential documents to this email address

Cell Phone

Please enter a valid phone number.Format: (000) 000-0000.

OK to call, text, or leave a discreet voicemail at this phone number.

Work Phone

Please enter a valid phone number.Format: (000) 000-0000.

Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Mailing Address and Residence are the same?

Texas Residence Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Texas County of Residence

Are You Married?

Spouse's Full Legal Name (if you are married)

Do you have any children?

Do you have any children who are minors?

Have you previously executed a will?

Do you have a copy of any previously executed will?

Designated Contact Person

Is the person needing estate planning services the person who we should contact?

If the designated contact person is not the person needing legal representation, please provide the following information:

Designated Contact's Full Legal Name

Designated Contact's Relationship to Person Needing Representation

Designated Contact's Email

example@example.com

Designated Contact's Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Estate Plan Package Selection

We recommend the $2,500 Comprehensive Package, which includes the following 8 documents:
(1) Last Will and Testament;
(2) Medical Power of Attorney;
(3) Directive to Physicians;
(4) Statutory Durable Power of Attorney;
(5) HIPAA Release;
(6) Declaration of Appointment of Guardian for Children;
(7) Designation of Agent for Disposition of Remains; and
(8) Declaration of Guardian in the Event of Later Incapacity or Later Need of Guardian.

Alternatively, the $2,000 Select Package lets you choose up to 4 of the above documents.

I'm interested in the

If interested in the Select Package, choose up to 4 of the following documents:

Any Additional Information

How did you hear about Kirker Davis?

Other

I was referred by: Name

I found you on:

KD Estate Planning Intake Form

KD Estate Form

Consult email

conexample@example.com

Intake email

conexample@example.com

I understand this sheet is for informational purposes only and does not create an attorney-client relationship. If I choose to retain the services of Kirker Davis, LLP, I will be required to sign an Agreement for Legal Services and provide payment if required before any services are provided.

Signature

Date

Potential Client Intake Form