Trial Level Client Intake Form

Trial Level potential client Intake Form

IMPORTANT: You must complete the form as required and click SUBMIT at the bottom of the page for it to be sent.

* Indicates required field

Potential Client Name *

First

Last

Age *

Phone Number *

Your Name *

First

Last

Phone Number *

Email *

Best time to call you by phone? *

Day Afternoon Evening Anytime

Address *

Line 1

Line 2

City

State

Zip Code

Country

If Yes or arraignment has been scheduled enter the date *

Briefly describe the facts of the case *

How would the police describe the facts? What do they think happened? *

Is the potential client able to post a cash bond? How much cash are they able to provide towards the bond? *

Does the potential client have property to post a Property Bond? If so where is it located and approximate value? *

Where was the arrest made? Include date and time? If no arrest, how does the client know they are under investigation? *

Is there a current lawyer handling the case? If so, Who and do they know you are contacting us? Can we contact them? *

Briefly describe what Success would be? What is your goal in this case? *

Any additional details you think we should know? *

How did you find us? *

Attorney Referral Family/Friend, Previous Client Internet Search Other

Name of person or Attorney referring you *

Submitting this form is for intake review purposes only and does not constitute an attorney client relationship.

Submit