SLF - Website Intake Form

SLF - Contact Us (Intake Form)
Please answer the questions below to the best of your ability.

This will allow you to provide the information needed to allow our office to gather
initial information, conduct a basic case screening, and run a conflict check through
our system.

When you submit this form and schedule a consultation using a link provided at the
bottom of this page we will follow up with you to confirm the consultation as well as
request any further documents/information of which we may need.

Please ensure that you only provide an email where you can SAFELY receive contact
and you are confident is not being monitored, or able to be monitored, by ANY 3rd
parties.
What is your first name?*
What is your last name?*
Upload a copy/photo of your Drivers License*

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What is the best phone number for us to reach you?*
What is your email address?*
example@example.com
What is your home address?*
What is your occupation and employer?*
Your Marital Status*

A never-married man/womanMarriedDivorcedDivorced and since remarriedA widow/erCommon Law Married
If you are currently married - provide the name, phone number, email address, and home address of your spouse
What type of matter you are seeking assistance with **

Estate Planning (EP) - GeneralEP - Young Adult Protection PlanEP - Gestational CarrierAdoption - GeneralAdoption -Uncontested FinalizationAdoption - Step Parent AdoptionSurrogacy/Assisted Reproduction - GeneralSurrogacy - Gestational Surrogacy AgreementFamily Law Mediation (I will potentially be conducting the mediation)Family Law/Divorce Consulting (no court appearances)
Please use this space to provide any additional information about what you would like to speak with us about. **
How did you hear about our firm?

FacebookGoogleFriendFamilyOther
If you were referred by an individual, please provide their name
Are there any upcoming deadlines or court dates, if so please provide details if not simply write N/A*
Consultation Scheduling
What day(s) would be best for you to schedule a consultation, between the hours of 9am and 4pm, would be:*

MondayTuesdayWednesdayThursdayFriday
What method would you prefer to utilize to conduct the consultation:*

Telephonic [1 hour] (all documents/pleadings/court orders/etc must be emailed in 24 hours in advance of the consultation)Video [40 minute] (all documents/pleadings/court orders/etc must be emailed in 24 hours in advance of the consultation)
24 hours in advance of the consultation it is necessary that you (1) provide the $200 consultation fee utilizing the links of which will be provided via email, (2) email all documents/pleadings/court orders/etc, (3) advise if you intend to have any 3rd party participate in the consultation with you, (4) a copy of your driver's license or other form of identification*
EMAIL: Upon completing this form we will be in touch with you via email. As such it is necessary to monitor your email and SPAM setting. Upon payment of your consultation we will confirm your selected consultation time via email.*

I agree
I understand that by completing and providing the information as contained in this intake form I am only doing so for the purpose of obtaining a consultation with the Melinda Jackson of Scissortail Law Firm.*

I agree
During your consultation, we will discuss in general the process involved in your matter, strategy, factors a court may consider, and any other relevant related topics.*

I agree
The consultation requires the payment of a consultation fee of $200 via electronic payment. This fee is for the consultation only and it not a retainer for future services.*

I agree
Although we may discuss a number of issues, until you formally retain (hire) our office, we do NOT represent you in your action. Following your consultation, should you choose to retain Melinda Jackson of Scissortail Law Firm a specific appointment for that purpose will be set, whether today or in the future.*

I agree
To schedule your consultation as quickly as possible it is recommended you copy the link below and use it upon completing this intake form to schedule a meeting on your calendar that best fits your schedule. If we do not receive a notification that a consultation has been scheduled within a few days of your intake submission we will email you to follow up. https://calendly.com/attorney_melinda/slfconsultation*

Understood
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SLF - Contact Us (Intake Form)

Consultation Scheduling