Information Request Form

Why We Request an Assessment Prior to Consultation

Modern Split Media works with a small, highly curated group of family law firms (or matrimonial groups within a firm) at any given time. Our work is deep, strategic, and highly customized, which means we are selective about who we partner with and how we engage.

Every engagement - without exception - begins with a Client Fit Assessment submission.

Please know that all information gathered is held in the strictest confidence and will never be shared.

Name

First NameLast Name

Name of Firm

What is your role in the firm?

E-mail

example@example.com

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Size of Firm

Practice Focus

Are you the person who can approve a consulting engagement in the $12,000 to $25,000+ USD range?

Requested Start Date:

Because Modern Split Media limits partnerships to one firm per market, we need to understand potential conflicts and competitive overlap. Which firms do you see as your closest competitors in your primary geographic area? Please list firm names and the city/region they serve.

What case management and practice management software is your firm currently running on? (No wrong answers, we just want to meet your systems where they are).

Do you serve any of the following?

Besides you, who else will influence or approve a decision to engage a firm like Modern Split Media?

Who outside your firm currently has decision-making influence over marketing, branding, intake, or client experience? Please list vendors, agencies, or consultants and their scope of authority.

Where do you believe your firm is most exposed right now? What prompted you to request a consultation?

On a scale of 1–10, how confident are you in your firm’s current client experience? Please explain your answer.

What do clients most often complain about?

What do your staff privately complain about?

Have you experienced any of the following in the past 24 months?

When it comes to improving your firm's client experience and growth, which best reflects your approach?

Which best reflects what you are prepared to invest to fix your client experience if it's the right fit?

Which statement best fits your firm?

Where do things most often break down? (Check all that apply)

Which of the above do you believe currently costs your firm the most in lost revenue, reputation, or client trust?

Which of these best describes your firm right now? (Check all that apply)

Our process involves leadership participation, extensive internal review, and honest and direct communication about changes to how your firm operates. Does that feel:

Are you seeking a long-term advisory relationship or a quick fix?

If Modern Split Media was wildly successful for your firm, what would be different 12 months from now?

Anything else we should know while reviewing your Client Fit Assessment?

Thank you for your interest in working with Modern Split Media!

What Happens Next

Once your assessment is submitted, our team will carefully review your responses. You will hear from us within one business day with either next steps or a brief follow-up request.

Because of the bespoke nature of our work, not every firm is a fit, but every assessment is reviewed personally and thoughtfully.