General Information

Preferred Contact & Scheduling

Preferred Contact Method

Select an option Email Phone No Preference

Do you prefer morning or afternoon appointments?

Morning

What day(s) of the week is best?

Afternoon

What day(s) of the week is best?

Personal & Employment Information

Gender

Male

Female

Marital Status

Single

Married

Spouse's Full Name

Separated

Spouse's Full Name

Divorced

Former Spouse's Full Name

Widowed

Former Spouse's Full Name

Are you currently employed?

Yes

Employer Name Job Title Employer Phone Number Employer Address Current Salary

No

If No: Please provide a brief explanation of your current financial situation. For example, are you receiving unemployment benefits, disability, spousal support, or other forms of financial assistance? If you have no income, how are you meeting your living expenses? This information helps us assess any financial considerations in your case.

Does the opposing party have an income?

Yes

If yes, what is their estimated monthly income?

No

Case Details

What area of family law does your case fall under?

Select an option Divorce Child Custody Child Support Adoption Guardianship Protective Order Modification Paternity Other

Please provide a brief description of your legal matter.

Full name of opposing party (i.e. spouse, other parent)

What is your relationship to the opposing party?

Select an option Spouse Ex-Spouse Other Family Member Other

Is your case currently active in court?

Select an option Yes, a case has already been filed No, a case has not been filed yet I’m not sure

If a case has been filed, what is the case number (if known)?

In which county is your case or legal matter located? (Please provide the county where the legal issue occurred or where the court proceeding will take place, if applicable.)

What stage is your case currently in?

Select an option No legal action has been taken yet We are in the early stages (petitions filed, but no hearings yet) We have upcoming hearings scheduled There is a final court order in place, but I need modifications Other (please explain)

Are there any existing court orders in your case?

Yes

Court Name/Location Cause Number Date of Order Please Describe Current Orders

No

Has another attorney ever represented you in THIS case?

Yes

Name of Attorney

No

Did Clay Harrison ever preside over your case as a judge?

Yes

No

Have you or the opposing party filed any legal documents regarding this matter?

Select an option Yes No Unsure

Are there any upcoming court dates scheduled?

Yes

If yes, when is the next court date?

No

If yes, what was filed and when?

Divorce-Specific Questions (If Applicable)

Are you currently married to the opposing party?

Select an option Yes Yes, but separated No, we are already divorced No, we were never married

If you are married, have divorce papers been filed?

Select an option Yes, I filed Yes, the other party filed No

Date of separation:

Date of marriage:

Is there a prenuptial or postnuptial agreement in place?

Select an option Yes No Unsure

What assets and debts are involved in the divorce? (Check all that apply)

Real EstateRetirement AccountsVehiclesBusiness InterestsCredit Card DebtOther LoansOther

Are you and your spouse in agreement on division of property and debts?

Yes

No

Unsure

Are there allegations of domestic violence or abuse in your case?

Yes

No

Has a protective order been issued for either party?

Yes

If yes, who filed protective order?

No

Children (If Applicable)

Do you and the opposing party have children together?

Yes

No

How many children are involved in this case?

What is the current custody arrangement?

Select an option Sole Custody (You) Sole Custody (Opposing Party) Joint Custody No Formal Custody Arrangement Other

Other (please explain)

Are there existing court orders for child custody, visitation, or support?

Yes

No

Are you seeking a modification of child custody or child support?

Select an option Yes No Unsure

Has the other parent been cooperative with custody/visitation arrangements?

Yes

No

Are there any allegations of abuse, neglect, or domestic violence involving the children?

Select an option Yes No Unsure

Are you concerned about the other parent’s ability to care for the children?

Select an option Yes No Unsure

Financial & Property Information

Are there any significant assets or debts that need to be divided?

Yes

No

Do you or the opposing party own real estate together?

Yes

No

Are you or the opposing party seeking spousal support (alimony)?

Yes

No

Has the other party hired an attorney

Yes

No

Additional Legal Considerations (If Applicable)

Are you or the opposing party involved in any criminal cases?

Select an option Yes No Unsure

Have there been any allegations of domestic violence in this case?

Yes

No

Do you have any concerns regarding substance abuse by the opposing party?

Yes

No

Are there any protective orders or restraining orders in place?

Yes

No

Final Screening Questions

What are your main goals in this case?

What are your biggest concerns regarding this case?

Are there any deadlines or upcoming hearings we should know about?

Referral & Payment Information

How were you referred to our law firm?

Friend or family member

Input the person's full name:

Another attorney

Input the attorney's full name:

Current/Past Client of the firm

Input the person's full name:

For example, "Avvo", "Facebook", or "LawFirmName.com"

Facebook

Google Search

Word of mouth

Other

Please explain how you found us:

Are you prepared to move forward with hiring an attorney if we take your case?

Yes

No

If our firm represents you, how do you plan to pay for legal fees?

Select an option I will pay personally A family member or friend will assist I am seeking financial assistance or payment plans

Name and phone number of family member or friend who will assist in the payment of the legal fees:

If we are unable to assist you with your legal matter, may we refer you to another attorney?

Yes

If yes, do we have your permission to share your contact information with that attorney? (Yes/No)

No

ACKNOWLEDGEMENT AND ACCEPTANCE

I acknowledge that I have read and hereby accept the above privacy policy regarding use of my personal information.

THANK YOU