Consultation Intake Form

Disclaimer & Consultation Policy

Thank you for your interest in scheduling a consultation with my office. Please note that completing this form does not create an attorney–client relationship. Legal representation begins only after a written agreement is signed by both parties.

Our consultations are conducted over the phone and are designed to provide general legal guidance based on the information you provide.

Consultation Fee: $75 (up to 30 minutes). Payment is required to confirm your appointment. After submitting this form, I will review your information and contact you by email with payment instructions and a link to schedule your consultation.

Please do not include sensitive or confidential information until you are formally a client. Consultation fees are flat, non-refundable, and considered earned upon payment to reserve your appointment.

Preferred Name*

Date of Birth*

Date

Gender*

Primary Language*

Email Address*

example@example.com

Phone Number*

Please enter a valid phone number.

Best Time to Reach You*

Preferred Method of Contact*

EmailPhone CallText Message

Consultation Type*

Immigration ConsultationFamily Law Consultation

Opposing Party's Full Name (write NA if not applicable)*

Opposing Party's Date of Birth (type in 01/01/1900 if not applicable)*

Date

Brief Description of Your Legal Issue or Question (3-5 sentences max, please do not include sensitive information)*

Are there any urgent deadlines or upcoming court dates related to your matter?*

YesNo

Have you worked with an attorney about this matter before?*

YesNo

Do you feel safe discussing your situation via email or phone?*

Yes, both are fineOnly emailOnly phoneNo, please suggest an alternative

What is your current immigration status?*

Are you currently in removal or deportation proceedings?*

YesNoNot Sure

Do you have any upcoming deadlines with USCIS or immigration court?*

YesNo

How did you hear about our services?*

What is your main priority in seeking legal help right now?*

0/100