Intake Form (Fam)

Intake Form

Complete this form to help us evaluate your case. Submitting it does not guarantee that we will accept your case.
Client Information
Full Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Date of Birth

MonthDayYear
Date
Type of Case
Do you have children?
Divorce Section
Date of Marriage

MonthDayYear
Date
Place of Marriage
Date of Separation

MonthDayYear
Date
Has the case already been filed?
Case Number
County
Spouse Name

First NameMiddle NameLast Name
Spouse Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Spouse Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Spouse Email
example@example.com
How many children?
Child 1 Name

First NameMiddle NameLast Name
Child 1 Age
Child 1 Date of Birth

MonthDayYear
Date
Child 2 Name

First NameMiddle NameLast Name
Child 2 Age
Child 2 Date of Birth

MonthDayYear
Date
Child 3 Name

First NameMiddle NameLast Name
Child 3 Age
Child 3 Date of Birth

MonthDayYear
Date
Child 4 Name

First NameLast Name
Child 4 Age
Child 4 Date of Birth

MonthDayYear
Date
Child 5 Name

First NameLast Name
Child 5 Age
Child 5 Date of Birth

MonthDayYear
Date
Child 6 Name

First NameLast Name
Child 6 Age
Child 6 Date of Birth

MonthDayYear
Date
Time Sharing Since Date of Separation
Child Support Paid Since Date of Separation
Are there assets and debts?
How much marital debt is owed?
House Asset
Vehicle Asset
Number of Vehicles
Vehicle 1 Details
Vehicle 2 Details
Vehicle 3 Details
Savings Amount
Retirement Accounts
Husband Income
Husband Employer
Husband Occupation
Wife Income
Wife Employer
Wife Occupation
Paternity Section
I Am the
Has the case already been filed?
Case Number
County
Other Parent Name
Other Parent Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Other Parent Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Other Parent Email
example@example.com
How Many Children?
Child 1 Name
Child 1 Age
Child 2 Name
Child 2 Age
Child 3 Name
Child 3 Age
Child 4 Name
Child 4 Age
Child 5 Name
Child 5 Age
Child 6 Name
Child 6 Age
Timesharing and Support History
Father Income
Father Employer
Father Occupation
Mother Income
Mother Employer
Mother Occupation
Modification – Child Support Section
Has child support been established?
How was child support established?
The year child support was established
What is the established amount?
Modification – Alimony Section
Do you receive or ordered to pay alimony?
The year the alimony was established
What is the established amount?
Modification – Timesharing ("Custody") Section
Describe your current timesharing ("custody")
How would you like to modify the current timesharing ("custody")?
Enforcement ("Custody," Child Support, or Alimony) Section
What are you seeking to enforce?
Please describe the enforcement issues you would like to pursue
Other (Prenup, etc.) Section
Please describe your issue and what you would like to pursue
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Intake Form

Client Information

Divorce Section

Paternity Section

Modification – Child Support Section

Modification – Alimony Section

Modification – Timesharing ("Custody") Section

Enforcement ("Custody," Child Support, or Alimony) Section

Other (Prenup, etc.) Section