Intake Sheet (Divorce/Separation)
This form will provide the firm with some basic information related to your situation and will assist us in providing you with advice most relevant to your situation. Please know that the contents of this document are secure and will be reviewed and maintained subject to the requirements of attorney/client privilege. All information provided in your responses to this form will be treated as confidential information and privileged communication.

This form is for consultations related to divorce or separation. If you are coming for a consultation related to another matter (eg: custody, child support, orders of protection, prenuptial agreements or any other family law matter) please use the Intake Sheet (Other) form instead of this form.

Email address *
Client Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Mobile Phone Number
Your answer
May we call you at your mobile number?
May we text you at your mobile number?
Social Security Number
Your answer
Home Address
Your answer
Mailing Address
Your answer
May we send you mail?
May we communicate with you by email?
Spouse's Name
Your answer
Spouse's Date of Birth
MM
/
DD
/
YYYY
Spouse Social Security Number
Your answer
Marriage Date
MM
/
DD
/
YYYY
Marriage Location (City/Town, State, County)
Your answer
Marriage Ceremony Type
Do You Have Children?
Have you been married before?
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