Collette Law Client Intake Form

Complete the form online or download the blank Word form and upload the completed copy.

Manual option

Download the blank Word form, complete it, then drag and drop the finished DOCX or PDF here.

Download blank form

Upload completed form

Client Name *

Matter Type *

Drag and drop completed file here
DOCX or PDF only. Click here only as a fallback.

Online Intake Form

Client Information

Date *

Full Name *

Address *

State *

Zip *

County

How long at address

Date of Birth

Last 3 Digits of Driver License

Last 3 Digits of SSN

Phone *

Email *

Employment and Marriage Information

Employer

Employer Phone

Employer Address

Monthly Income

Date of Marriage

Date ceased to live together

City and State of Marriage

Maiden Name

Spouse Information, if family law matter

Full Name

County

Address

Date of Birth

Last 3 Digits of Driver License

Last 3 Digits of SSN

Phone

Employer

Start Year

Employer Address

Employer Phone

Monthly Income

Children, if family law matter

Add as many children as are involved in the lawsuit. The first four match the original paper form, and additional children will be included in the generated document payload.

Description of Legal Issue Type of Case

Requesting name change?

Has a case been filed?

Have you been served?

When?

Main Legal Issue *

How did you hear about our law firm?

Notice and Waiver of Conflict of Interest

I understand that consultation alone does not constitute the formation of an attorney-client relationship and that no attorney-client relationship exists unless and until required payments are made and an Employment Agreement is signed by all required parties.

Signature *

Draw signature Type signature

Signature Date *