Intake Questionnaire: Justice for Immigrants & Families Project
The Florence Immigrant & Refugee Rights Project, in partnership with the Phoenix Legal Action Network, provides quality, free legal representation to non-detained adults facing imminent deportation in Maricopa County through its Justice for Immigrant & Families Project. To apply for our services, please fill out this questionnaire. We will review all your responses and be in touch with you soon. Completing this intake questionnaire does NOT mean the Florence Project will be your lawyer.
Full Name (first, last): *
Your answer
A# (if known):
Your answer
Best/Preferred Language *
Your answer
Gender *
Mailing Address (street, city, state, zip code): *
Your answer
Phone Number: *
Your answer
Email (optional):
Your answer
How did you hear about our services? *
Your answer
What is your estimated annual income? If married and living with spouse, list combined income. *
How many children (under 18 years old) live with you? *
Your answer
How many adults live with you? *
Your answer
Are you currently undocumented? If no, please list what type of status you have and the date of expiration in the comments section below. *
Why do you need an immigration attorney right now? *
Your answer
Comments: Any other information about your immigration situation that you would like us to consider.
Some possible questions to consider: Have you ever been directly threatened or harmed in your home country? Have you ever been directly threatened or harmed in the United States? Have you ever made a police report in the United States? Are you afraid of returning to your country of origin? If so, why?
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Florence Immigrant and Refugee Rights Project Inc.. Report Abuse - Terms of Service