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Form preview Law firm client intake form The reader must conduct independent research and analysis to determine all possible and appropriate legal and ethical issues that might apply to a specific situation and the best way to address these issues in the jurisdiction where the reader is located. Sample Law Firm Intake Form Please note This form should be modified to meet the facts of the individual case. Client Contact Information Name Address Home Phone Cell Phone Work Emergency Contact Name Phone Number Marital Status Married Single Divorced Widowed Separated Drivers License Social Security Are you known by any other names Yes No If yes name s C--21 E-Mail Many e-mail attorney-client communications involve relatively innocuous information and do not present a great concern even if they are intercepted. On the other hand any communication from an attorney that can be accessed by others may be of concern in some situations. WARNING AND DISCLAIMER The information herein was prepared by The Bar Plan Mutual Insurance Company for general information purposes and should not be construed as legal advice or legal opinion with regard to any specific circumstance or set of facts. The reader must conduct independent research and analysis to determine all possible and appropriate legal and ethical issues that might apply to a specific situation and the best way to address these issues in the jurisdiction where the reader is located* Sample Law Firm Intake Form Please note This form should be modified to meet the facts of the individual case. Client Contact Information Name Address Home Phone Cell Phone Work Emergency Contact Name Phone Number Marital Status Married Single Divorced Widowed Separated Drivers License Social Security Are you known by any other names Yes No If yes name s C--21 E-Mail Many e-mail attorney-client communications involve relatively innocuous information and do not present a great concern even if they are intercepted* On the other hand any communication from an attorney that can be accessed by others may be of concern in some situations. Please think carefully about your email process. Do other persons who are not parties to this matter have access to the email For example if e-mailing from home does your spouse or other family also have access to the computer and e-mail program If e-mailing from work does your company reserve the right to view all e-mail traffic on their servers By and large most do. Any unprotected access to our e-mail and if so the communication may be available for review and use by the adverse party. Anytime you communicate with your attorney include only the attorney in the family friends relatives or ANYONE else. Where is the computer you use for e-mail Does anyone else use or have the ability to use that computer Is that computer connected to a network E-mail Address C--22 Where are you currently employed May we contact you there If your mail is returned as undeliverable or telephone service terminated please provide the name of someone friend or relative you believe will always know how to contact you.

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