Legal Consent to Refer Form

LEGAL CONSENT TO REFER FORM

This Legal Consent to Refer Form (the "Consent") is entered into on Effective Date: by and between Client Name: (hereinafter "Client"), and Referring Party Name: (hereinafter "Referring Party"). The Client and the Referring Party are collectively referred to as the "Parties."

RECITALS

WHEREAS, the Client has sought advice or representation from the Referring Party regarding certain legal matters described below; and

WHEREAS, the Referring Party proposes to refer the Client's matter to the Referred Attorney or Entity identified below and requires the Client's informed, written consent to disclose information and effect the referral; and

WHEREAS, the Client understands the nature and extent of the referral, potential disclosure of information, and the terms under which the referral will occur.

NOW, THEREFORE

In consideration of the mutual covenants contained herein, the Parties agree as follows:

1. DEFINITIONS

1.1 "Referred Party" means the attorney or entity to whom the Referring Party will make the referral. Referred Party Name: ; Referred Party Address:

2. SCOPE OF CONSENT

2.1 The Client expressly authorizes the Referring Party to disclose Client information, including confidential communications, case files, documents, and other materials reasonably necessary to effectuate the referral described below (the "Referral Materials"). The scope of the referral is:

2.2 The Client consents to transfer of the Referral Materials to the Referred Party for the purpose of evaluation, potential engagement, or continued representation. This consent extends to any agents or staff of the Referred Party reasonably involved in the representation.

3. LIMITATIONS ON DISCLOSURE

3.1 The Referring Party shall disclose only such information as is reasonably necessary to accomplish the referral. The Referring Party will not disclose privileged communications that the Client has expressly directed remain confidential, except with the Client's separate written authorization.

3.2 The Client acknowledges that the Referred Party may request additional information. Any further disclosure beyond the Referral Materials will require additional written consent unless permitted by applicable law.

4. CONFIDENTIALITY AND DATA SECURITY

4.1 Each Party agrees to maintain the confidentiality of client information in compliance with applicable ethical obligations and to take commercially reasonable measures to protect electronic and physical records containing the Referral Materials.

4.2 The Referred Party shall be responsible for security of information once received. The Referring Party shall retain copies only as required by law or professional obligations.

5. CONFLICTS OF INTEREST

5.1 The Referring Party represents that, to the best of its knowledge, no unwaivable conflicts exist at the time of this referral. The Referred Party shall undertake a conflicts check upon receipt of the Referral Materials and shall promptly notify the Client and Referring Party of any discovered conflict that would preclude representation.

6. REFERRAL FEES

6.1 The Parties acknowledge that a referral fee may be paid to the Referring Party by the Referred Party. The Client hereby consents to payment of a referral fee, if any, consistent with applicable rules of professional conduct and provided that the Client's interests are not compromised. Referral Fee Arrangement:

6.2 The Client's consent to a referral fee is not an authorization for the Referring Party to receive any portion of client funds absent a separate written agreement signed by the Client.

7. NO GUARANTEE OF OUTCOME

7.1 The Client acknowledges that referral does not guarantee engagement by the Referred Party, nor does it create any warranty or guarantee concerning the results of any legal matter.

8. TERM, REVOCATION AND WITHDRAWAL

8.1 This Consent is effective as of the Effective Date and shall remain in effect until revoked in writing by the Client. Revocation shall not prejudice disclosures already made in reliance on this Consent, nor shall revocation affect any obligations or fees incurred prior to receipt of the revocation.

9. NOTICES

9.1 Any notice under this Consent shall be in writing and delivered by personal delivery, certified mail, or email to the addresses provided below. Notice is effective upon receipt.

10. AMENDMENT; WAIVER

10.1 No amendment or waiver of any provision of this Consent shall be effective unless in a writing signed by the Party against whom enforcement is sought. No waiver by any Party of any breach shall be construed as a waiver of any subsequent breach.

11. GOVERNING LAW

11.1 This Consent shall be governed by and construed in accordance with the laws of the jurisdiction indicated below, without regard to conflict of laws principles. Governing State:

12. ENTIRE AGREEMENT; SEVERABILITY; COUNTERPARTS

12.1 This Consent constitutes the entire agreement between the Parties with respect to the subject matter hereof and supersedes all prior agreements and understandings, whether written or oral. If any provision of this Consent is held invalid or unenforceable, the remainder of this Consent shall remain in full force and effect. This Consent may be executed in counterparts, each of which shall be deemed an original and all of which together constitute one instrument.

13. REPRESENTATIONS AND CERTIFICATIONS

13.1 The Client represents that the Client has the authority to provide the consent set forth herein and that the consent is given voluntarily after adequate opportunity to ask questions and seek independent advice. The Referring Party certifies that the referral is made in accordance with applicable ethical rules.

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