Corporate Wellness Program Intake

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Full Name* This field is required.Please provide the name of the person who will serve as the main contact for this engagement.

First Name

Last Name

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Email* This field is required.Please provide the email address for all correspondence.

example@example.com

3

Phone* This field is required. Please provide the best phone number to reach you.

Area Code

Phone Number

4

Do you currently work with a tax professional?* This field is required.CPA, enrolled agent, tax preparer, bookkeeper, or financial advisor — your entity structure and ongoing compliance have real tax consequences, and I want to make sure we're making decisions that work for your full financial picture.

YESNO

5

Your Tax Professional* This field is required.Please provide the details of your tax professional. I coordinate with them to ensure your corporate structure supports your tax strategy. This collaboration is required to maximize the tax benefits of your entity structure and ensure everything works together properly.

First Name

Last Name

Title/Role

Email Address

Phone Number

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I can't move forward without a tax professional in place.Entity structure, S-corp elections, and ongoing compliance all affect your tax situation, and I coordinate directly with your CPA to make sure nothing falls through the cracks. If you have questions, feel free to schedule a free consultation with me.

7

Do you have a legal entity (LLC, Corporation, etc.) that's already been filed with the state?

YESNO

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Entity Name* This field is required.What's the exact name of your entity?

Entity Name (as it appears on your formation documents)

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Where did you incorporate?* This field is required.This is the state on your Articles - your business's "home state"

State where you incorporated

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If you have your Articles of Incorporation or Articles of Organization handy, feel free to upload them now. Don't worry if you don't have them - I can look them up.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

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Who currently serves as your registered agent?* This field is required.Registered agent service is included, or you may continue with your current arrangement.

I serve as my own

Commercial service (LegalZoom, CorpNet, etc.)

My CPA/ attorney

I don't know

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Your Options* This field is required.Registered agent service is included in your Corporate Wellness Program. If you're self-serving or using a CPA/attorney as your registered agent, you may continue with that arrangement or switch to my service — I'll discuss your options in the assessment.

I understand

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Registered Agent Review* This field is required.Registered agent service is included in your Corporate Wellness Program. I'll review your entity's state records to identify your current registered agent and provide an analysis in your Corporate Wellness Assessment.

I understand

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Registered Agent Transition RequiredRegistered agent service is included in your Corporate Wellness Program. If you're using a commercial registered agent service, I'll need you to switch to my service for coordination purposes. Having multiple providers often causes confusion when clients receive conflicting information about filings. If you know the name of your current commercial service, please provide it here and I'll facilitate the transition.

(e.g., Incfile, LegalZoom, Northwest)

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Proposed Entity Name* This field is required.To set up your file and begin the formation process, I'll need your desired entity name. We'll handle entity type selection and other details in our follow-up consultation.

Desired Business Name

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*California Formation Requirement* This field is required.I only form entities in California, which works well for many businesses, especially those based here or planning significant operations in the state. Once your company is formed, I can provide corporate wellness services nationwide and assist with registrations in other states as your business expands. Will California formation work for your business?

Yes, California formation works for my business

I'm not sure - I need guidance on this

No - I need to incorporate in a different state

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Formation Strategy Consultation* This field is required.I provide comprehensive formation guidance including state selection, entity type, tax elections, and naming requirements. Let's schedule a consultation to discuss your specific business formation needs.

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Out of State Formation Strategy & Corporate Wellness Consultation* This field is required.Perfect! I'll be happy to discuss referral options for out-of-state formation services and how I can support your ongoing corporate wellness needs once your entity is established. Please use the scheduling link below to book a convenient time for our consultation:

19

Let's Explore Your Options* This field is required.I see you're considering formation outside California! Since I'm licensed only in California, I focus exclusively on California formation. I often find California formation works better than people expect. I'd love to understand your situation and explore whether California makes sense, or if out-of-state formation is better for you. If out-of-state is the right path, I can provide qualified referrals and then assist with ongoing corporate wellness services nationwide once your entity is formed. Let's schedule a consultation to discuss what works best for your business!

Yes, Schedule a Call

No Thanks

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How did you hear about my services?

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Who referred you?* This field is required.

First Name

Last Name

22

Please tell me how:

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Terms & Conditions* This field is required.By submitting this form, you acknowledge that you have reviewed the Privacy Policy and Terms of Use. Submission does not create an attorney-client relationship or obligate Mallori Rose Law to represent you. Please do not submit confidential details or sensitive personal information beyond what is requested unless we ask you to do so.