Good Legal Firm Client Intake Form-1983

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

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

Email

example@example.com

County of Matter

Case Numbers

What are the names and date of births of your children involved in this matter?

Please Provide a Brief Summary of Your Case (please include important dates)

Is your DFCS matter still pending/case open?

If so, who is your current attorney?

Do you currently have an attorney for your civil suit? If so, who?

Were your children removed due to the allegations of abuse/neglect?

Were you and your children reunified?

If not, was your parental rights terminated?

What are the allegations of your case?

Do you currently have an open criminal case?

Is your criminal case related to the DFCS matter?

If so, please provide the following information: County of case; charges; next court date; your attorney's name.

What is the name of the hospital involved in your matter? (If no hospital please put n/a)

Please share with us what laws/rights you believe were violated?

How/when were those violated in your opinon?

Are you currently represented by an attorney?

If so, who is your current attorney?

What is your ultimate goal for representation?

Do you have any documents regarding your case that may show the violations? (Court orders, safety plans, etc.) If so, please email them to us at welcome@goodlegalfirm.com

What is the best days and times for your free consultation?

Acknowledgment

The purpose of this initial consultation is to determine if our firm can assist you with your legal needs, to inform you about the services our firm provides, and to discuss the potential agreement for the provision of legal services and the formation of an attorney-client relationship. This initial consultation does not create an attorney-client relationship and does not mean our law firm will act as your legal counsel.

After the initial consultation, if your case or matter is accepted, we will provide you with a written agreement (or engagement agreement) which will set forth the terms and conditions for our legal services. Upon receipt of a signed agreement by you, and the required retainer amount, the attorney-client relationship will commence.

Your legal rights may be affected by laws that place time restrictions on certain legal claims or may be otherwise affected if prompt action is not taken. If our law firm does not accept your case or matter, or you decide not to retain our services, you should seek alternate legal counsel immediately to ensure that your legal rights are not affected.