Ted Broomfield Intake & Appointment Request

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Please (1) answer questions; (2) click submit at the bottom of the page; and (3) when you receive your own responses in email then click here to schedule your intake appointment. Please do not schedule an intake before submitting your responses.

Email *

2.a. First Name *

2.b. Last Name

3. Telephone number *

4. Do you consent to being sent SMS text messages?

Yes

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BY CLICKING YES THE USER CONSENTS TO RECEIVING MESSAGES

The user agrees to receive promotional messages by SMS; the promotional messages are merely administrative communications for purposes of scheduling and other logistics.

Consent is not a condition of purchase.

The estimate of messages is approximately 4 messages per month during relationship. Such messages are not to solicit new sales but for administrative and logistical purchases.

OPT OUT - Type STOP to stop receiving messages.

Below is a link to Ted Broomfield's Privacy Policy

5. Ted Broomfield Law Privacy Policy [Click to view]

6. If you are a Legal Shield Member, Legal Shield File Number

7. Your full address, starting with street number, then street name, unit, if any, city, two letter state abbreviation and zip code *

8. Legal Issue *

I am a tenant and my landlord wants to evict me

I am a landlord and I want to evict my tenant

I want to sue another person or business for money

I have been sued and I need to respond to that lawsuit

I am either seeking a restraining order or someone is seeking a restraining order against me

I need assistance with trust or estate administration, including help getting money or property

I want to make or update an estate plan

Other:

9. Please list the full names of each opposing party and please separate each name by a comma.

10. A consultation is free, however, after the consultation, Ted Broomfield requires compensation to provide services. How do you expect to pay for the services? *

I may be willing to pay an hourly rate with a deposit in advance

I want a contingency-based payment arrangement, meaning I would like to share a portion of whatever is recovered with Ted Broomfield

I want Ted Broomfield to provide services without compensation

Answering the above question does NOT obligate you to hire Ted Broomfield and it does NOT make Ted Broomfield your attorney. Submitting an intake and receiving an initial consultation does NOT obligate you to hire or pay Ted Broomfield.

11. Date of Birth

YYYY

12. As consideration for a consultation, I promise not to communicate a negative description of Ted Broomfield or his services. *

Yes

By clicking submit, you agree to the terms herein and to share your answers with Ted Broomfield for the purposes of an initial consultation. This form does not create an attorney-client relationship.

THANK YOU!

A copy of your responses will be emailed to the address you provided.

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This form was created inside of Broomfield Law.