Intake Form

Name *
Name
Please add middle name and preferred name.
Phone *
Phone
Preferred contact method *
Current Address *
Current Address
Professional References
Reference 1 *
Reference 1
Unless you have previously provided this information, please provide name, professional relationship, phone number, and email address for three professional references. Provide at least two supervisors and a reference from your current or most recent completed position.
Phone *
Phone
Reference 2
Reference 2
Phone *
Phone
Reference 3
Reference 3
Phone
Phone
Employment Experience
Practice Areas
Indicate experience in years next to any practice area in which you are interested in being matched
Have you ever worked for any of the employers listed on your resume under a different name?
Have you ever been involuntarily terminated or offered an opportunity to resign in lieu of termination?
Are you registered with any other legal services companies?
Do you carry professional liability insurance?
Have you ever been subject to a State Bar or comparable disciplinary proceeding?
Has your law license ever been suspended, canceled, or revoked for any reason (including suspensions related to nonpayment of fees or failure to obtain CLE hours)?