Client Online Intake Form

INSTRUCTIONS:  Answer all questions truthfully and completely.  The information you enter in this questionnaire is confidential and protected by Attorney-Client Privilege.  The information will not be disclosed to anyone outside of this office, except in the course of rendering legal services on your behalf, or unless otherwise required by law.

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If YES, please answer the questions below:

If applicable:

Names and birth dates of all children common to the parties:

Nature of case / Reason for seeking consultation with our office:

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Located in Clermont, Florida with over 40 years of combined experience, our successes are numerous and our motivation is simple; to deliver the most effective results for each and every one of our valued clients

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