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Client Information Sheet - (Section I)
Instructions: Please complete sections I and II completely and thoroughly. If you have any questions, please do not hesitate to contact our office at (704) 542-2525. If a question does not apply to your case, please put "N/A."
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Date: *
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Your Full Legal Name: *
Preferred Name: *
Your Physical Address: *
Your Mailing Address (if not the same as above):
How long have you lived at this address? *
Your Telephone Number (Cell): *
Can we leave a message at your cell number? *
Can we send you occasional SMS (text) messages regarding appointment reminders and other important case updates? *
Your Telephone Number (Home): *
Can we leave a message at your home number? *
Your Telephone Number (Work): *
Can we leave a message at your work number? *
Your Email address: *
Your Employer's Name: *
Your Employer's Address: *
Your Social Security # (You can provide this over the phone if you are not comfortable completing this section on the web form):
Your Birth Date: *
MM
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DD
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YYYY
Referred by: *
Please provide an overview of your legal need: *
Provide as much detail as you can regarding your legal concerns and your desired outcomes. 
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