Client Intake
Filled out by our Staff
Date:
MM
/
DD
/
YYYY
Organization or Individual's Full Legal Name: *
Your answer
City:
Your answer
State
Your answer
Zip Code
Your answer
Point of Contact (POC) for this Request for Legal Assistance: *
Your answer
Title of POC: *
Your answer
Email of POC: *
Your answer
Billing Point of Contact (Name):
Your answer
Billing Point of Contact (Email):
Your answer
Central Point of Contact for Gathering Client Information (Name):
If there is someone you would like us to contact when requesting general information (i.e. Organization Chart, personnel filings, etc.)? - Optional
Your answer
Central Point of Contact for Gathering Client Information (Email):
Your answer
Method of Payment for Services:
All payment information is held confidential
Does your Organization have a preferred method of receiving updates on legal services provided?
Status updates will be provided upon request and to advise on major events surrounding legal services.
Does your Organization have its own form for filling out miscellaneous costs and expenses (i.e. mileage invoices)?
Billing rates discussed:
Your answer
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