Initial Client Consultation Information Form

The purpose of my initial consultation is for me to advise you as a prospective client what, if anything, may be done for you, and what the minimum fee and retainer will be. The purpose is not to render a definitive legal opinion, as it will not be possible for me to fully assess your matter during an initial consultation.

One of three outcomes is possible following your initial consultation:

1. You may decline to use my services

2. I may decline to represent you, or

3. You and I mutually agree to the terms of representation.

The questions in this form will help me to understand your goals. Your responses are protected by attorney/client privilege and will be held in strict confidence.

If you agree to hire me and I agree to represent you, then we will both sign an Agreement for Representation following your initial consultation. The Agreement for Representation will set forth the terms and conditions of representation.

This office does not represent you with regard to the matter set forth by you herein in this information sheet or discussed during your consultation, unless and until, we both execute a written Agreement for Representation.

If I do 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 me during your consultation. If your legal problem(s) involve a potential lawsuit, it is important that you realize that a lawsuit must be filed within a certain period of time called a Statute of Limitations. Therefore, I strongly urge you to immediately consult with another attorney to protect your rights. My decision not to represent you should not be taken by you as an expression regarding the merits of your case.

By filling out this form, you are only providing information to me as a potential client. This does not mean that you have hired an attorney.



email address:
daytime phone:
night phone:
mobile phone:
mailing address:
What do you need assistance with?
What is your ideal outcome?
What can you accept?
What is your urgency in concluding this matter?
Critical! Personal safety or continuation of your 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.
Not immediate. Needs to be done, but no immediate hardship in the interim.
Idea. You have an idea and you want to see if it is worth pursuing, but you're not counting on anything.
Rights? You just want to know what your rights are in your situation. You'll decide after you know more.
Am I the first attorney that you have consulted regarding this matter?


If not, then what other attorney have you consulted and why did you not hire their services?