Legal Attorney Intake Form

LEGAL ATTORNEY INTAKE FORM

This Attorney-Client Intake Agreement (the Agreement) is made as of Effective Date: by and between Client Name: and Attorney/Firm Name: (collectively, the Parties).

Recitals

WHEREAS, the Client seeks legal services in connection with the matter described below and requests that the Attorney provide legal representation and related services; and

WHEREAS, the Attorney represents that the Attorney is duly authorized and qualified to provide legal services in the relevant practice area and is willing to represent the Client subject to the terms and conditions set forth in this Agreement; and

WHEREAS, the Parties desire to set forth their respective rights, duties and responsibilities regarding the representation.

NOW, THEREFORE, in consideration of the mutual covenants contained herein and other good and valuable consideration, the receipt and sufficiency of which are acknowledged, the Parties agree as follows.

1. Scope of Representation

The Attorney will provide legal services to the Client limited to the following matter (the Matter):

The Attorney is not authorized to undertake matters beyond the Matter described above unless the Parties execute a written amendment in accordance with Section 13. The Attorney may associate other attorneys or consultants when reasonably necessary.

2. Fees and Billing

The Client agrees to compensate the Attorney in accordance with one of the following fee arrangements (select one or more as applicable):

Hourly fee at $ per hour (time is recorded in increments of 0.1 hour).

Flat fee of $ for the Matter, subject to the scope set forth above.

Contingency fee of of recovery, exclusive of costs. If selected, a separate contingency agreement shall be attached and incorporated.

Retainer funds will be deposited into Attorney's client trust account and applied to fees and costs as earned and incurred in accordance with applicable professional conduct rules. Unused funds, if any, will be returned to the Client upon final accounting.

3. Billing Procedures and Costs

The Attorney will render periodic statements describing fees, costs and disbursements. Payment is due within 30 days of invoice unless otherwise agreed in writing. Costs advanced by the Attorney (filing fees, deposition fees, expert fees, travel, courier, etc.) are the Client's responsibility.

Check Credit/Debit Card ACH/Wire Transfer

4. Client Responsibilities

The Client agrees to cooperate fully, provide truthful and complete information, disclose all known documents and witnesses, pay fees and costs when due, and keep the Attorney informed of any change in contact information.

5. Conflicts and Prior Representation

The Attorney has conducted a conflicts check based on the information provided. The Client must promptly disclose any relationships, prior adverse parties, or matters that could give rise to a conflict of interest.

Yes No

6. Confidentiality and Use of Information

The Attorney shall maintain the confidentiality of information provided by the Client to the extent required by applicable law and the rules of professional conduct. The Client authorizes the Attorney to disclose confidential information where necessary to carry out the representation or as otherwise required by law.

The Client expressly consents to the Attorney's reasonable use of electronic communications (email, text messages) for routine communications, recognizing that such communications may not be entirely secure.

Consent to electronic communication:

7. Termination of Representation

Either Party may terminate the representation upon written notice. Upon termination, the Client remains responsible for all fees and costs incurred through the date of termination, including a reasonable charge for wind-down activities necessary to conclude the Attorney's services.

8. Client Records and File Retention

Upon conclusion of the Matter and after payment of all outstanding fees and costs, the Attorney will, at Client's request, provide the Client with original documents. The Attorney may retain copies of the file. The Client authorizes destruction of the file after a reasonable retention period unless otherwise requested in writing.

Retention instruction:

9. Notices

All formal notices under this Agreement shall be in writing and delivered to the addresses set forth below or to such other address as a Party may designate by written notice in accordance with this Section.

10. Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to its conflicts of law principles.

11. Entire Agreement

This Agreement, together with any separate written fee agreements or exhibits expressly incorporated herein, constitutes the entire agreement between the Parties with respect to the subject matter hereof and supersedes all prior discussions and agreements.

12. Severability

If any provision of this Agreement is held to be invalid or unenforceable, the remaining provisions shall remain in full force and effect and the invalid provision shall be reformed only to the extent necessary to make it enforceable.

13. Amendments and Waiver

Any amendment or modification of this Agreement must be in writing and signed by both Parties. The failure of either Party to enforce any provision shall not constitute a waiver of that provision.

14. Counterparts

This Agreement may be executed in counterparts, each of which shall be deemed an original, and all of which together shall constitute one instrument. Signatures transmitted by electronic means shall be deemed original signatures.

15. Acknowledgment and Certification

The Client certifies that all information provided in this intake form is true and complete to the best of Client's knowledge. The Client authorizes the Attorney to proceed with the representation on the terms set forth in this Agreement.

Client hereby acknowledges receipt of this Agreement and consents to its terms:

Additional Information

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