Love & Norris Intake Form

Thank you for contacting Love & Norris, attorneys at law.

The answers to the questions below enable the firm to facilitate the process of providing legal counsel, and provide client referrals where appropriate. This information also allows the firm to conduct a conflicts check.

All legal opinions are given with an understanding that without ACTUAL knowledge or investigation of the facts and circumstances involved, our attorneys are limited to the information offered by telephone or face-to-face consultation.

Some circumstances involve extensive representation, and cannot be resolved with limited hourly work.

COMPLETING THIS FORM DOES NOT CREATE AN ATTORNEY CLIENT RELATIONSHIP BETWEEN YOU AND THE LAW FIRM OF LOVE & NORRIS.

NOTE: If this matter involves an allegation or suspicion of abuse that has not been reported to relevant criminal or child protection authorities, please be aware that attorneys are commonly listed as 'mandatory reporters' in state reporting statutes related to child sexual abuse. In many states (including Texas), ALL ADULTS are mandatory reporters of suspicions or allegations of sexual abuse.

Please feel free to contact the firm with any questions or concerns.

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Name *
Date of birth *
Phone number *
Email address *
Address *
Male or Female
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When did the sexual abuse occur? *
In what city/cities and state(s) did the abuse occur? What organization was involved? Did any of the sexual abuse occur at the physical location of the organization? *
How old were you at the time of the sexual abuse? How long did the abuse occur? *
What is the name of the perpetrator? Do you have any additional information related to him or her? *
What is the perpetrator's relationship to you? *
Did the perpetrator hold a position of authority within the organization? *
Was the offense reported to organizational supervisors? If so, what action did they take? On what date was the report made? *
Was the offense reported to law enforcement? If so, on what date? *
Are you aware of any other victims of the perpetrator, before or after your abuse? *
Is the perpetrator still involved in the organization? *
Are you affiliated in any way with the organization currently? *
Please use this space to provide any additional information that may assist the attorneys.
Date of request for legal consultation: *
By checking this box, I understand that attorneys are commonly listed as 'mandatory reporters' in state reporting statutes related to child sexual abuse. In many states, ALL ADULTS are mandatory reporters of suspicions or allegations of sexual abuse. *
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