INITIAL INTAKE QUESTIONNAIRE (Confidential)
The transmission and receipt of information contained on this Web site, in whole or in part, or communication with EA Law via the Internet or e-mail through this website does not constitute or create a lawyer-client relationship between us and any recipient. You should not send us any confidential information in response to this webpage. Such responses will not create a lawyer-client relationship, and whatever you disclose to us will not be privileged or confidential unless we have agreed to act as your legal counsel and you have executed a written engagement agreement with EA Law.
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Email *
Name: *
Address *
Gender *
Age *
Nationality *
Contact Number *
Occupation *
Company / Place of Work *
Type of Consultation *
Please schedule the consultation during office hours, i.e., M-F, 9:00 am to 4:00 am
Choose 3 preferred dates
The date of consultation will depend upon the availability of the lawyers.
Date 1 *
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Time *
Time
:
Date 2 *
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DD
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YYYY
Time *
Time
:
Date 3 *
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DD
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YYYY
Time *
Time
:
Nature of Case *
Indicate whether the case is an administrative, criminal, civil, labor case, corporate matter, or others.
Referred By
Name of Previous Counsel, If any
Case Filed, If any
Status
General Overview of the case (DO NOT DISCLOSE CONFIDENTIAL INFORMATION, SUCH AS NAMES OR IDENTITY OF PERSONS OR COMPANIES INVOLVED)
PLEASE READ
No attorney-client relationship shall exist between client and this office by virtue of this questionnaire or consultation, unless and until client formally retains our services pursuant to a written retainer agreement, signed by us, and client pays any applicable attorney fees and costs for such services. There may be deadlines, due dates, court hearings, interview dates, etc., in connection with the case. However, this consultation and/or submitting this questionnaire does not obligate our office to represent the client, make any appearances, file any documents, or provide any legal services on client’s behalf. No prediction, warranty, or guarantee can be made on the outcome of your case. Our advice during the consultation constitutes our opinion concerning the merits or chances with respect to your case. One of our attorneys will contact you in connection with your consultation.
ACKNOWLEDGEMENT AND CONSENT
By submitting this form, you affirm the information and facts given are true and correct based on personal knowledge and/or on authentic records in my possession; you have read EA Law’s privacy policy and online consultation policy; you are agreeing to the collection and use of your personal information by Estrada & Aquino Law for purposes of giving legal services.
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