Family Law Intake Form

*Name:

*Address:

*City:

*State:
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*Zip:

*E-mail address:

*Home Phone:

Business Phone:

Cellular or Pager:

Facsimile:

What type of family law matter are you interested in?
Choose One Adoption Alimony Support Annulment Child Custody Child Support Cohabitation Civil Union Divorce Dissolution Modifications Divorce Decree International Adoption Legal Separation Prenuptial Agreement Protective Order Visitation Other

Are you currently married or cohabiting?
Yes  No 

Check one:
Married  Cohabiting 

If yes, list his or her name, date of birth, and date of marriage/cohabitation:

Do you have children?
Yes  No 

If yes, list their names and dates of birth:

If you have children, with whom and where do they live now?

Were you previously married?
Yes  No 

If yes, when and how did your previous marriage(s) end?

Is your case contested or do you anticipate you will meet opposition to your anticipated actions?
Yes  No 

Have you been served with papers in a family law matter?
Yes  No 

If yes, what is the name of the opposing party and his or her attorney (if known)?

What is your relationship with the opposing party?
Choose One Spouse Former Spouse Cohabitant Co-parent Other Relationship

If "Other Relationship," please explain:

Have you appeared in court or agreed on terms related to this matter?
Yes  No 

Do you have copies of any documents (court decrees, dissolution agreements, etc.) related to this matter?
Yes  No 

What types of documents do you have?

Is domestic violence an issue in this matter?
Yes  No 

If yes, please describe, including any court actions and incident dates.

Is property at issue?
Yes  No 

If yes, please describe the property and anything known with regard to legal ownership.

Are you or any person involved in this matter currently pregnant?
Yes  No 

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