Potential New Client Form

    Just a few things I want to be sure you know before we run the conflict check.

    There is a $200 fee for the consultation for Ms. Storey.

    The initial retainer is $2500.00 and is never applied to the bills - it stays in the trust account until the case is over and then is returned to you in full. Also, retainer funds cannot be paid by credit card; cash, check or certified funds.

    We bill monthly, due by the 20th of the following month; however, if you pay by the end of day on the 10th, you get a 10% discount.

    Ms. Storey's hourly rate is $400.00 an hour.

    Today's Date

    Can I get your full name?

    Have you ever gone by any other names?

    What is the best phone number to reach you at?

    What is the best e-mail address for you?

    Do you currently have an attorney?

    Name of Attorney:

    How did you hear about us today?

    What is the other parties name?

    Has the other party ever gone by any other names?

    Do they currently have an attorney?

    Name of Attorney:

    What kind of case are you calling about?

    Are there any children involved in this case?

    How old are the children?
    Age Child #1
    Age Child #2
    Age Child #3
    Age Child #4
    Age Child #5

    What county is this case in?

    Is anything currently filed with the courts?

    Currently court status:
    Date Served:

    Other Comments:

    Preference for attorney in our firm:

    ____________________________________________________________________________________________

    Person submitting the form:

    Thank you for that information.

    Someone will contact you by e-mail within the next 24-48 hours with the result of the conflict check. At that time, they will be able to schedule your initial consultation.

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      Brief Description of Legal Issue:

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