Initial Consultation and Assessment Form

Initial Consultation and Assessment Form

Client Legal Name

First NameLast Name
Citizenship

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Citizenship (If more than 1)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Marital Status
Do you have children?

Children Information - If applicable

Rows	Name	Age	Marital Status
1
2
3
4
5

Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
E-mail Address
example@example.com
Birth Date

MonthDayYear
Permanent Home Address

Street Address Line 1

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How many years did you live in this country?
Current Address (if different from above). Leave blank if same as above.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How many years did you live in this country?
Did you live in other foreign country, other than the above addresses? If yes, enter the address. If no, leave this blank.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How many years did you live in this country?
Your Employment History
Current Occupation
Previous Occupation:
Previous Occupation:
Previous Occupation:
Previous Occupation:

Educational Attainment
What is the highest level of education you attained?
Please list the Degree/s you completed.
Name/Address of University
Has your post-secondary education credentials have been assessed within the last 5 years?
Please specify if what is the educational equivalency and if assessment was done by CES, ICAS, ICES, IQAS, MIDI or WES.
Has your English and/or French language proficiency been tested within the last 2 years?
Please specify if which test was taken - IELTS, CELPIP, TEF, etc.
What are your scores?
Please specify if you are a member of a Professional Organization or Regulating body in any Country. Provide details.

- Spouse/Common Law Name
  
  First NameLast Name
- Citizenship
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Citizenship (If more than 1)
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Age
- Do you live with your spouse/common law partner?
- Home Address (If different than spouse/common law partner)
  
  Street Address Line 1
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- How many years did you live in this country?
- Did you live in other foreign country, other than the above addresses? If yes, enter the address. If no, leave this blank.
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- How many years did you live in this country?
- Your Employment History
- Current Occupation:
- Previous Occupation:
- Previous Occupation:
- Previous Occupation:
- Previous Occupation:
- Educational Attainment
- What is the highest level of education you attained?
- Please list the degree/s you completed.
- Name/Address of University
- Has your post-secondary education credentials have been assessed within the last 5 years?
- Please specify if what is the educational equivalency and if assessment was done by CES, ICAS, ICES, IQAS, MIDI or WES.
- Has your English and/or French language proficiency been tested within the last 2 years?
- Please specify if which test was taken - IELTS, CELPIP, TEF, etc.
- What are your scores?
- Please specify if you are a member of a Professional Organization or Regulating body in any Country. Provide details.

- Which Canadian City and Province do you want to visit, work, study in or immigrate to?
- Have you previously applied to come to Canada?
- Have you been previously denied entry to Canada?
- If you previously applied or denied entry to Canada, provide more details.
- Have you visited, studied, or worked in Canada?
- If yes, Enter Canadian travel details
- If yes, Enter Canadian travel details
- Have your spouse/common law partner visited, studied, or worked in Canada? (If applicable)
- If yes, Enter Canadian travel details
- If yes, Enter Canadian travel details
- Do you or your spouse/common law partner have any family in Canada? Please specify the relationship, province and immigration status of the family members.
- If you or your spouse are currently in Canada, enter more details of current immigration status and permit validity.
- Is there a possibility of obtaining a job offer in Canada? Provide more details.
- How much money do you currently have to settle in Canada? Total in Canadian dollars.

- Do you or any of your family members have a medical condition for which you are currently receiving treatment?
- If yes, please specify.
- Do you or any of your family members have criminal convictions or outstanding charges?
- If yes, please specify.
- Have you previously hired an Immigration Consultant/Lawyer to assist with your immigration matters?
- If yes, please provide more details.
- FREE TEXT FORM - Please share your immigration goals in Canada and any additional comments or important information not covered in the questionnaire that may help us guide you on your immigration journey.
- This is the end of the form. The next steps will appear after you submit it. Thank you for completing the form!
Should be Empty:

Initial Consultation and Assessment Form

Your Employment History

Educational Attainment

Your Employment History

Educational Attainment

This is the end of the form. The next steps will appear after you submit it. Thank you for completing the form!