Intake Form

The purpose of an initial consultation is for the attorney to advise you, the prospective client, what may be done for you, if anything, and what the minimum fee will be to perform any services.

The purpose is not to render a definitive legal opinion as it may be impossible to fully evaluate 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.

Note: The following questions will assist us in understanding the reason for your visit today. Your responses are required but are protected by the attorney/client privilege and will be held in strict confidence.


    PhoneEmail




    Are there any other parties involved? (Including witnesses, parties or employers on the other side
    of your issue):


    (NOTE: Any documents you supply that are important to your matter will be copied, with your
    permission, and your originals will be returned to you at the conclusion of the initial interview.)


    YesNo


    Friend/Family Member
    Online Search Engine
    Advertisement
    Another Lawyer
    One of Our Employees
    Former Client of Ours
    Referral Group
    Other

    Following your initial interview, if you agree to hire our Firm, 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 encouraged 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 on 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, the Attorney does not represent you in 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 issue(s) involve a potential lawsuit, it is important that you realize that a lawsuit must be filed within a certain period of time, within any applicable Statute of Limitations set forth by Florida law. 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 as an expression regarding the merits of your case.

    Any information discussed today pertaining to this matter is strictly confidential and will not be disclosed to any third party outside of this office unless required by law.

    Your signature acknowledges only that you received a copy of this completed Information Sheet
    and does not mean that you have hired the Attorney.