New Client Intake Form

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Your First and Last Name *

Phone Number *

Occupation

Your Address

What is your preferred method of communication

Telephone

Either email or telephone

Clear selection

What type of legal services do you require?

Family Law (in court)

Family Law (Separation Agreement, Marriage Contract, Out of court negotiations)

Fertility Law ( Sperm Donor, Ova Donor, Surrogacy Contracts)

Child Protection

What issue do you require help with? *

Parenting Time (access)

Decision Making Responsibility (Custody)

Child Support

Divorce

Division of Matrimonial Property

Spousal Support

Adoption

Other

Required

Is your matter currently in court? If so, what is the next court date and for what step.

Name of the opposing party and their lawyer, if any. *

Have you had any previous legal representation? If yes, who. *

Please note that submitted an intake form does not constitute a solicitor client relationship. *

Agreed

Were you referred to Chaput Law by anyone?

What are your most pressing concerns, if any? *

Payment of Legal Fees *

I have a legal aid certificate.

I will be getting a legal aid certificate

I would like to hire Chaput Law private at $250.00 per hour and a retainer of $3,000.00

Please note that if you are a privately paying client there is a consult fee of $300.00 for a 60 minute consult. Should you continue your services with Ms. Chaput you will be credited the amount towards your retainer. *

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