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General Case Evaluation Form

NOTE: Bolded labels and * indicates REQUIRED information. The use of the Internet or this form for communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Confidential or time-sensitive information should not be sent through this form.

Name:*

Address:*

City:*

State:*

ZIP Code:*

E-mail Address:*

Home Phone:*

Business Phone:

Cellular or Pager:

Facsimile:

Are you known by any other names?

If yes, list other names you have used:

What is your marital status?

Does this matter involve a business you own or run?

If yes, provide the business name, address, and phone:

If a business is involved, how is the business organized (if known)?

Are you employed?

If yes, please provide your job title and employer's name and address.

Can you be contacted at work?

What area of law does your situation involve (if known)?

Describe your situation, including any relevant dates:

How would you rate your legal needs described here?

Are any other people involved?

If yes, provide names, addresses (if known), and their relationship to you, if any:

Do you have any documents that could help explain your situation?

If yes, list those documents and their dates:

Are there other documents that you do not have access to that could be of assistance?

If yes, list those documents and their dates and locations (if known):

Describe how this situation has impacted you:

Describe what you would like to happen to resolve your issue (your preferred outcome):

Have other attorneys worked on this matter?

If yes, provide names, addresses, and a brief description of their involvement:

Special concerns:

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