*** Please Read This Important Information Prior to Completing This Form ***

This Prospective Client Intake Form is used by us to determine, first and foremost, whether we have any actual or potential conflicts of interest that may prevent us from being able to represent you. Assuming there are no conflicts of interest, we then review the form to get a general overview of your case, so that we can determine whether, in our opinion, it is advisable for us to schedule an initial consultation appointment with you to discuss your legal matter further. Please understand that no attorney-client relationship is formed by your submitting this intake form and/or by your supplying us with any other documents, information, or materials related to your case. We may not be able to treat any such information as confidential and privileged.

If we schedule an initial consultation appointment with you (whether in person or by telephone), any information and documents that we discuss and review in preparation for, during, and after the consultation will be confidential and protected by the attorney-client privilege, regardless of whether we ultimately end up representing you in connection with your legal matter. Therefore, if you have information that you would like to keep confidential, please hold it until after the time that we have scheduled our initial consultation.
Should you have any questions or concerns, please call our office. Thank you.

If you prefer to download and return a hardcopy of the Prospective Client Intake Form, please click Here.

ACKNOWLEDGMENT
“I have read and understood the above information and consent to completing this Prospective Client Intake Form.”

Please provide the following contact information:


If this matter is for your business or organization, please also list the entity's name and your title.












For what type of legal matter are you seeking a consultation?

Additional Description (if you selected "Other"):

How did you find out about our Firm?

(Please specify name of person, publication, or referral source.)

Additional Description:

Are we the first attorneys you have consulted with respect to this matter?

(If not, then please state the name(s) of the attorney(s) with whom you consulted previously and the reasons you did not engage them.)

YesNo

Please list the names of the other persons or parties (if any) who are involved in this transaction or dispute.


Please state briefly the reasons you are contacting us today.  What would you like to see happen?

Please describe, in a brief and succinct manner, the relevant facts regarding your legal issue. Try to include answers to the six "Basic Questions": "Who," "What," "When," "Where," "Why," and "How."  Give names, dates, places, relevant position titles, etc.

What is the relative urgency of your situation?

CriticalVery ImportantImportantJust Checking

How would you propose to pay for your attorneys' fees and expenses in this matter?

(Legal fees can often be significant in any case, and planning for them at the outset is essential to the success of your matter. Like other major investments, you should consider all available sources of financing, including: bank loans, credit cards, home equity lines, 401(k) loans, loans from relatives and friends, etc.)

Are there any particular questions/issues that you would like for us to cover in our initial meeting?

Please review your form carefully for accuracy and completeness.  Also, make sure that you have read and reviewed the information at the top of this form regarding confidentiality, and that you have initialed the box at the top of this form indicating your understanding of the same.  We will make every effort to review your form as soon as possible and get back in contact with you in regard to setting up an appointment.

Intake form
BoltNagi, PC