LEGAL CLIENT CONSULTATION FORM
This Legal Client Consultation Form is designed to gather essential information from potential clients during initial consultations. Providing accurate details about your legal matter, goals, and concerns will help us better understand your needs and determine how we can assist you. Your privacy and confidentiality are of utmost importance to us, and the information provided will be handled with the strictest confidence. Thank you for taking the time to complete this form.
Client Information:
Full Name: [Client Name]
Phone Number: [Client Number]
Date of Birth: [Date]
Occupation: [Occupation]
Employer: [Employer]
Legal Matter Details:
Field | Information Provided |
|---|
Type of Legal Issue | Personal Injury |
Brief Description | Slip and fall accident at Jandra Mall resulting in injuries |
Date of Incident | 02/15/2024 |
Relevant Documents | Medical records Incident report Witness statements |
Witnesses | Sarah Johnson (555-777-1234) Mark Smith (555-777-5678) |
Previous Representation | No |
Goals and Expectations:
Field | Information Provided |
|---|
Desired Outcome | Compensation for medical expenses and lost wages |
Timeframe | None |
Budget | Open |
Questions or Concerns | How long will the legal process take? |
Additional Comments:
Client mentioned ongoing physical therapy sessions. |
Declaration:
I hereby declare that the information provided in this consultation form is true and accurate to the best of my knowledge.
Client's Signature:
Date:
Disclaimer:
This consultation form is for informational purposes only and does not constitute legal advice or create an attorney-client relationship. The information provided in this form will be kept confidential in accordance with applicable laws and regulations.
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