Client Intake Form - J. L. Williamson Law Group

Client Intake Form

Name*
First Middle Last
Address*
Street Address City State / Province / Region ZIP / Postal Code
Primary Phone Number*
Secondary Phone Number
Facsimile
Email*
Marital Status*
Are you a veteran?*
Is your spouse a veteran?*
Occupation*
Employer*
Is it okay to contact you at work?*
What kind of representation are you requesting?*
- Tax Controversy (Representation Before the IRS or United States Tax Court)
- Estate Planning (Wills, Trusts, Powers of Attorney, Advance Directives, Etc.)
- Medicaid, Nursing Home, or Long-Term Care Planning
- Special Needs Planning
- Veterans Administration Pension Planning
- Business Entity Formation or Reformation (Corporations, LLCs, Partnerships)
- Other
If you answered "Other," describe what you are requesting assistance with below.*
How did you learn about our firm?
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