Thank you so much for contacting our law office. Please read the privacy policy below, and then fill out this form in its entirety prior to our consultation.

Confidential Client History

The following questionnaire is designed to help you more accurately provide information that will help us prepare court pleadings on your behalf. Please complete this form as fully and comprehensively as possible. If exact information is not known, please provide your best estimate. You may be asked at some future date to provide more precise information.

Confidential information provided on this form is protected by the attorney-client privilege and is intended for the use of your legal counsel. Any information provided in this form which is detrimental to you will not be revealed by counsel without your consent unless it is in your best interests to do so except in certain narrow and limited situations required or authorized by law. If you have any questions about the confidentiality of this information we will be pleased to answer them. Because this information is provided in confidence, we ask that your answers be as truthful, complete and accurate as possible.

If you are the defendant in a restraining order case, you MUST return to the Court where the restraining order was issued and obtain a copy of the affidavit (written statement) that the plaintiff filled out against you. This is essential for our attorneys to review. We cannot book your intake appointment until you have a copy of the plaintiff’s affidavit

Privacy Policy

All information received from a client is strictly confidential. Our firm takes every step possible to protect your privacy. The data submitted via this form is encrypted and secured using industry-standard 256-bit SSL encryption.

Your Social Security number and other personal information will only be used in the event that you hire the firm to represent you in your legal matter, and then only when necessary in limited use during the course of your case.

Social Security numbers are most often used to positively identify parties. Most courts require Social Security numbers of all parties in a case. Some other examples of how this information may be used include:

  • initial service

  • in court orders

  • in required reports or other documents filed with the State

If you have any questions, please don't hesitate to contact our law office. We look forward to working with you.


Contact Information


Upon submission, a copy of this form will be sent to this email.


Select an Option

Phone Numbers



Phone Number



Do you Have in Your Possession:

*Required prior to your hearing


For each child, please select "Yes" and complete the requested information. If it's not applicable, please select "No".



We will contact you as soon as possible.

Please click the SUBMIT button when you have finished completing this form.