Clinic Appointment Request Form

Clinic Appointment Request Form

⚠️ If you are unresponsive to staff communications before the clinic, MDVLA reserves the right to cancel your clinic appointment. ⚠️ Our next clinics will take place on June 20th at Creative Suitland (4719 Silver Hill Rd, Suitland, MD 20746) & July 25th at Southeast CDC (3323 Eastern Ave STE 200, Baltimore, MD 21224). Please be sure that you are selecting the correct date, time slot, and location for your clinic appointment.
Request a clinic slot
Name

First NameLast Name
Email
example@example.com
Pronouns
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What county do you live in?
Birthday

MonthDayYear
Date
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Race
What type of artist are you?
What type of legal issue are you having?
Detailed description of legal issue
Do you have any files or documents that may need further review by an attorney?
Do you have a digital copy of these files or documents?
Please upload the relevant file. MDVLA will not accept documents exceeding 5 pages in length for review at the Art Law Clinic.

Cancelof
I understand that June's clinic will take place at Creative Suitland (4719 Silver Hill Rd, Suitland, MD 20746) with no virtual appointments and certify that I will attend in-person at my confirmed appointment time.
I understand that July's clinic will take place at Southeast CDC (3323 Eastern Ave STE 200, Baltimore, MD 21224) with no virtual appointments and certify that I will attend in-person at my confirmed appointment time.
Should be Empty: