Your Name *

First Name

Last Name

Phone *

(###)

###

####

Spouse’s Full Name *

First Name

Last Name

Spouse’s Date of Birth (if known)

MM

DD

YYYY

Spouse’s Phone Number (if applicable)

(###)

###

####

What type of legal matter are you seeking assistance with? *

Divorce

Child Custody

Child Support

Mediation

Spousal Support

Property Division

Other (please specify)

What stage are you in the legal process? *

Just considering options

Papers have been filed

Responding to a legal action

Other (please specify)

Are there any restraining orders or protective orders in place? *

Yes

No

Do you and your spouse agree on how to handle the legal matter? *

Yes

No

Unsure

Have you considered mediation? *

Yes

No

I’d like to learn more

Do you have children under 18? *

Yes

No

Are there any current custody arrangements? *

Yes

No

Are there significant shared assets (property, business, investments)? *

Yes

No

Are you currently employed? *

Yes

No

Spouse’s Employment Status (if known) *

Employed

Unemployed

Are you seeking financial support (spousal or child support)? *

Yes

No

Unsure