The purpose of an initial consultation is for the attorney to advise
you, the prospective client what if anything, may be done for you,
and what the minimum fee therefor will be. The purpose is not to render
a definitive legal opinion as it may be impossible to fully assess a
matter within the time frame allotted for a consultation or with the
(information or documents) that you may be able to provide at the initial
consultation.
One of three outcomes is possible following your consultation.
- You and the Attorney mutually agree to the terms of representation,
or
(After a separate document called an Agreement for Representation is
signed a copy will be provided to you.)
- The Attorney declines representation, or
- You decide not to use the services of the Attorney.
Note: The following questions will help us to understand the reason
for your visit today. Your responses are protected by attorney/client
privilege and will be held in strict confidence.
| Name |
____________________________________________________________ |
|
Last |
First |
Middle or Maiden |
| Address |
___________________________________________________________ |
|
Number
|
Street
|
City
|
State
|
Zip
|
| Home Phone |
(_____)
_____________ |
Briefly explain what you may need advice about or assistance with
today:
______________________________________________________________________
______________________________________________________________________
Are there any parties involved?
(Examples: a friend, an employer, a neighbor, signor of a contract,
etc. This should include parties on either side of your issue)
Party_____________________________
Relationship___________________________
Party_____________________________
Relationship___________________________
Party______________________________Relationship___________________________
On the lines below, list the documents (papers) that you think may help
us to understand the issues.
- _______________________________________________________________
- _______________________________________________________________
- _______________________________________________________________
(NOTE: Any documents you supply that are important to
your matter will be photocopied, with your permission, and your originals
returned to you at the conclusion of the initial interview.)
Ideally, if things turn out precisely the way you want, what would the
outcome be?
_________________________________________________________________________
_________________________________________________________________________
Knowing that there are no guarantees, what can you accept?
_________________________________________________________________________
_________________________________________________________________________
Please classify your urgency in concluding this matter? (check one)
[ ] Critical – Personal safety or continuation of business depends on
it.
[ ] Very important – severe hardship, personal or financial
inconvenience if matter is not resolved quickly.
[ ] Important – Matter interferes with business or personal financial
stability.
[ ] Needs to be done, but no immediate hardship in the interim.
[ ] Just thought I’d see if it was worth pursuing, but I’m not
counting on anything.
[ ] Just wanted to know what my rights are? I’ll then let you know after
I think about it.
If the matter involves payment of money you feel you are owed, how long
can you wait before not getting
paid?____________________________________________________
(Days, Weeks, Months, Years)
Are we the first attorneys you have consulted regarding this matter? [ ]
Yes [ ] No
If No – Why didn’t you hire their services?
_________________________________________________________________________
_________________________________________________________________________
Have you ever been represented by an attorney before? [ ] Yes [ ] No
If Yes – Please state the circumstances
_________________________________________________________________________
_________________________________________________________________________
How will you pay for your attorney’s fees in this matter?
[ ] Check today [ ] Cash today [ ] Contingency Fee [ ] On Account
[ ] Credit Card Credit Card No. ___________________________ Expr.
Date________
Marital Status: [ ] Married [ ] Single [ ] Divorced [ ] Widowed [ ]
Separated
Drivers License # ________________________ Social Security #____ __ ____
Are you known by any other names? [ ] Yes [ ] No
If yes name(s)
____________________________________________________________
(A fictitious name, a nickname, a former name, your maiden name etc.)
Where are you employed?
__________________________________________________
May we contact you there? [ ] Yes [ ] No Phone No. ( ___)
_________________
If your mail is returned as undeliverable or telephone service
terminated, please provide the name of someone (friend or relative) you
believe will always know how to contact you.
Name_____________________________________ Relationship___________________
Address ___________________________________ Phone No. (____)
______________
__________________________________________ State & Zip ______________
____
How did you learn of our office [ ] A friend [ ] Yellow Pages [ ] Bar
Referral
[ ] Our Web Page http:/ www.yourfirm’spage.com [ ] Former Client [
] Other
PLEASE READ CAREFULLY & Sign Below
Following your initial interview, if you agree to hire the Attorney, and
the Attorney agrees to represent you, you will both sign an Agreement for
Representation. The Agreement for Representation will set forth the terms
and conditions of representation.
If the Attorney is willing to represent you and you decide not to sign an
Agreement of Representation today, you are strongly urged to schedule a
second appointment with the Attorney at the earliest possible time or to
immediately consult with other legal counsel to protect your rights.
NOTICE: This office does not represent you with regard
to the matters set forth by you herein in this information sheet or
discussed during your consultation unless and until, both you and the
Attorney execute a written Agreement for Representation.
If the Attorney does not agree to represent you, this includes not
representing you with regard to the matter set forth by you on this
information sheet, nor any other matters you may discuss with the Attorney
during your consultation. If your legal problem(s) involve a potential
lawsuit, it is important that you realize a lawsuit must be filed within a
certain period of time called a Statute of Limitations. Therefore, the
Attorney strongly urges you to immediately consult with another attorney to
protect your rights. The Attorney’s decision not to represent you should
not be taken by you as an expression regarding the merits of your case.
Your signature acknowledges only that you received a copy of this
completed information sheet and does not mean you have hired the Attorney.
SIGNATURE ___________________________ DATE ____/____/ ____
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This portion to be completed by the
Attorney
[ ] Will represent (see New Case Memo and Agreement for Representation
attached)
[ ] Will investigate and report (Schedule a follow-up conference for ____
days)
[ ] Representation declined – Letter of declination will be sent .
[ ] Party "will think about it" and back with us – No action
to be taken and party was so informed.
[ ] Client declined Representation at this time.
Interviewed by __________________________ this ____ day of _________
_____
NOTES:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
