| *Name: |
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*Email Address: |
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| Company: |
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Street Address: |
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State, Zip |
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| Home Phone: |
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Business Phone: |
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| Cellular or Pager: |
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Facsimile: |
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| What type of family law matter are you interested?
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| Are you currently married or cohabiting?
Yes
No |
Check one:
Married
Cohabitating |
| If yes, list his or her name, date of
birth, and date of marriage/cohabitation: |
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| Do you have children?
Yes
No |
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| If yes, list their names and dates of birth. |
Name |
Date of Birth |
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| If you have children, with whom and where
do they live: |
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| Were you previously married?
Yes
No |
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| If yes, when and how did your previous
marriage(s) end? |
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| Is your case contested or do you anticipate
you will meet opposition to your anticipated actions?
Yes
No |
Have you been served with papers in a
family law matter?
Yes
No |
If yes, What is the name of the opposing
party and his or her attorney (if known)?
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| What is your relationship with the opposing party?
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If "Other Relationship", please
explain:
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Have you appeared in court or agreed on
terms related to this matter?
Yes
No |
Do you have copies of any documents (court
decrees, dissolution agreements, etc.) related to this matter?
Yes
No |
| What types of documents do you have? |
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| Is domestic violence an issue in this
matter?
Yes
No |
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| If yes, please describe, including any
court actions and incident dates: |
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| Is property at issue?
Yes
No |
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If yes, please describe the property and
anything known with regard to legal ownership:
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Are you or any person involved in this
matter currently pregnant?
Yes
No |
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| Where did you hear about this website?
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