*Name:

*Address:

*City:

*State:

*Zip:

*E-mail address:

*Home Phone:

Business Phone:

Cellular or Pager:

Facsimile:

What type of family law matter are you interested?

Are you currently married or cohabiting?

Check one:

If yes, list his or her name, date of birth, and date of marriage/cohabitation:

Do you have children?

If you have children, with whom and where do they live now?

Were you previously married?

If yes, when and how did your previous marriage(s) end?

Is your case contested or do you anticipate you will meet opposition to your anticipated actions?

Have you been served with papers in a family law matter?

If yes, What is the name of the opposing party and his or her attorney (if known)?

What is your relationship with the opposing party?

If "Other Relationship", please explain:

Have you appeared in court or agreed on terms related to this matter?

Do you have copies of any documents (court decrees, dissolution agreements, etc.) related to this matter?

What types of documents do you have?

Is domestic violence an issue in this matter?

If yes, please describe, including any court actions and incident dates:

Is property at issue?

If yes, please describe the property and anything known with regard to legal ownership:

Are you or any person involved in this matter currently pregnant?

Where did you hear about this website?