Client Information Form

This information helps ensure we are aware of any circumstances that could impact your claims or be raised by the opposing party, allowing us to anticipate issues, avoid conflicts, and position your case for the strongest possible outcome.

At this stage, the information you provide through this form is part of our attorney-client communications. While some information may later become relevant or discoverable in the course of litigation, this intake form itself is attorney-client communication and not shared with opposing parties.

⚠️ Please note: A separate Client Information Form is required for each named client.

Identity & Contact Information

Full Legal Name

How would you like to be addressed

What would you like us to call you (e.g., "Joe" instead of Joseph)

All prior names or aliases

Birthday

Month

Day

Year

Multi-line address

Country/Region

Address

City

Zip / Postal code

State of Residence

County of Residence

County where events took place, if different

Phone Number - preferred

Type of phone

Cell

Home/ landline

Work

Other

Alternate Phone Number

Type of phone

Cell

Home/ landline

Work

Other

Please upload a government-issued photo ID

e.g., driver license, state ID card, passport

Employment & General Background

Brief overview of your employment history over the past ten years. Please list each item using numbers. Example: 1) ABC, Inc. – Position – Dates; 2) Employer B – Position – Dates; 3) Employer C – Position – Dates

Include Employer Name - Job Title - Date Range

Describe any education, training, or work experience you have that may relate to the issues involved in your case, even if it seems indirect.

e.g., if your case involves a credit reporting error by a lender and you worked at a bank; or if your case involves a defective vehicle and you worked as a mechanic.

Family, Relationship & Household Information

ℹ️ Why we ask: Household members may later be relevant as witnesses, individuals with knowledge of key facts, or relevant to the harm you/they suffered.

Relationship Status

e.g,. married, widowed, separated, etc.

If applicable, identify any prior marriages or significant relationships that may be relevant—directly or indirectly—to your case, including those that existed during events related to this matter.

Are you currently involved in a divorce, separation, or custody matter

Household & Minor Children

Please identify (first and last name) all adults residing with you, and their relationship to you. Please list each person with numbers. E.g.,: 1) Sally Mae Smith - sister; 2) Robert Edward Marks - friend; 3) Allison Dee Banks - daughter (Ellie)'s friend

Please identify (first name only) all minors or dependents, including their ages. Please list each person using numbers. E.g., 1) Ellie - 16; 2) Teddy - 7; 3) Billy - 3

Prior Legal History

Prior lawsuits or legal proceedings. Please separately list matter using numbers (e.g., 1, 2, 3, ...) If none, state "none."

As a named party. E.g., plaintiff, defendant, etc.

Past bankruptcies. If none, state "none."

State years of each, as applicable.

If you are currently represented by another attorney in any other matter, please describe. If inapplicable, state "NA."

Please list any previous testimony you have given. Please number each instance separately. E.g., 1, 2, 3... If inapplicable, state "NA."

Any testimony under oath at a deposition, hearing, trial, etc. Please also include any sworn statement, such as an affidavit or declaration you have given in any court case.

Social Media & Online Presence

ℹ️ Why we ask: Social media content may become relevant or discoverable in litigation. We do not request any login credentials

List all social media platforms used and your handle or username on each. Separate each site by number. E.g., 1. Twitter - Sally1843; 2. Facebook - Sally Jensen If inapplicable, state "NA."

e.g., Facebook, Instagram, X, LinkedIn, TikTok, etc.

⚠️ Important Social Media Notice

Please be aware that social media activity may be discoverable in litigation. This means that, in some circumstances, the opposing party may request and obtain information from your social media accounts. We encourage you to be mindful of what appears on your social media accounts while your matter is pending. As a general precaution, you may also wish to review and use heightened privacy settings to reduce unintended access to your content.

If you have questions about social media use during your case, please raise them with our office so we can provide guidance tailored to your situation.

Special Considerations

Are there any personal circumstances or background factors you would like us to be aware of that may be relevant to your situation? (Check all that apply).

ℹ️ While our firm does not handle discrimination claims as a primary practice area, certain background factors can sometimes provide important context for how an issue arose, how it has impacted you, or how it may be evaluated. This information is entirely optional and is used solely to better understand your situation.

If you selected any of the above, please briefly explain how you believe this information may be relevant to your situation:

Practical Considerations

Please describe any accessibility needs or accommodations for in-person appearances. If inapplicable, state "NA."

Please list any upcoming travel or extended unavailability. If inapplicable, state "NA."

Please keep our office informed if this changes in the future.

I understand information shared on this form is material to my case, and I affirm that the information I have provided is true and accurate to the best of my knowledge.

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