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  • PROSPECTIVE CLIENT INTAKE FORM

    DEAR PROSPECTIVE CLIENT: 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 will be for that service. The purpose of the initial consultation is not to render a definitive legal opinion regarding your issue(s); 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 provide to the attorney at the initial consultation.

    PAYMENT FOR INITIAL CONSULT

    The potential client will be expected to pay in advance preferably at the home page of www.jblegalcounsel.com if there is no insurance coverage. If payment is not received consult will be rescheduled until payment in advance is received. One of three outcomes is possible following your initial consultation.
    1. 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.);
    2. The Attorney declines representation; or
    3. You decide not to use the services of the Attorney.
    Note: The following questions will help us to understand the reason for your contact with our firm and allows us to verify that we have no potential conflicts affecting our ability to represent you. Your responses will be held in strict confidence.

    IDENTIFICATION:

  • CONTACT INFORMATION

  • 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. This information is for the firm and will not be disclosed to opposing party.

  • EMPLOYMENT:

  • OTHER INVOLVED PERSONS/ATTORNEYS:

    Are there any people involved? (Examples: children*, a friend, an employer, neighbor, signor of a contract, etc. This should include people on either side of your issue)
  • *If a child is involved list the date of birth of the child(ren) in the Relationship field above.

    SUPPORTIVE DOCUMENTS:

    On the lines below, list the documents (papers) that you think may help us to understand the issues. Email the documents to us before the consult as well.
  • 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.

    DESIRED/ACCEPTABLE OUTCOME:

  • URGENCY REGARDING MATTER:

  • OTHER ATTORNEYS:

  • HOW YOU HEARD ABOUT OUR OFFICE:

  • PLEASE READ CAREFULLY & SIGN BELOW:

    Following your initial consultation with the attorney, if you agree to hire the attorney, and the attorney agrees to represent you, you will both sign a Fee Agreement. The Fee Agreement will set forth the terms and conditions of attorney’s representation. BEADVISED: This office does not represent you with regard to the issue(s)/matter(s) set forth by you herein in this Initial Consultation Form and/or discussed during your Initial Consultation unless and until, both you and the attorney execute a written Fee Agreement (and pay any retainer required thereunder as set forth in the Fee Agreement) and/or execute a Substitution of Attorney, if applicable.

    If the attorney is willing to represent you and you decide not to sign a Fee Agreement 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. If your legal issue(s)/matter(s) involve(s) 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. Failure to follow the timeline proscribed within the Statute of Limitations may result in you being unable to obtain any relief regarding the issue(s)/matter(s) for which you are seeking legal advice.

    If the attorney does not agree to represent you, the attorney will not disclose this information or or any other content you may discuss with the Attorney during your initial consultation. The attorney’s decision not to represent you should not be taken by you as an expression regarding the merits of your case. As indicated herein above, you do need to be mindful of the Statute of Limitations that may potentially affect your ability to obtain relief.

    YOUR SIGNATURE BELOW ONLY ACKNOWLEDGES THAT YOU HAVE RECEIVED THIS INFORMATION SHEET; AND DOES NOT MEAN YOU HAVE HIRED THE ATTORNEY TO REPRESENT YOU.

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