Information Request Form

Private Consultation Intake
Why We Require an Application

Modern Split Media works with a small, highly curated group of family law firms 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. Please know that all information gathered is held in the strictest of 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*
Because Modern Split Media limits partnerships to one firm per market, we need to understand potential 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?*

ExecutivesEntrepeneursPublic FiguresInternational FamiliesUltra-High Net Worth Individuals
Are you the person who can approve a consulting engagement in the $10k-$50k+ range?*
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? Yes, this matters. *
Have you experienced any of the following in the past 24 months?*

Excessive Client ComplaintsNegative ReviewsReputation DamageStaff Burnout or Increased TurnoverHigh Conflict Cases Consuming Disproportionate Time
When it comes to improving your firm's client experience and growth, which best reflects your approach?*

We look for the lowest-cost optionWe balance cost with long-term ROIWe prioritize results and brand impact over short-term cost
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)*

IntakeOnboardingCommunicationExpectationsStaff BandwidthClient EmotionsCase ClosingReferrals
Which of the above 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)*

Clients feel confused and anxiousWe spend too much time explaining basic conceptsOur intake and onboarding is inconsistentAttorneys are doing emotional labor they shouldn't beWe get complaints about communicationWe have received bad reviews despite solid legal workWe feel reactive instead of steady and in controlWe are scaling but it's messy
If accepted, our process involves leadership participation, honest internal review, and 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 before considering your application?*
Thank you for your interest in working with Modern Split Media!

What Happens Next

Once your application is submitted, our team will carefully review your responses. You will hear from us within two business days 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 application is reviewed personally and thoughtfully.
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Private Consultation Intake