ESTATE PLANNING SERVICES INTAKE FORM

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ESTATE PLANNING SERVICES INTAKE FORM

Full Name:

Phone Number:

Email Address

Preferred Contact Method

Phone Call

Text

E-mail

Service Needs

1. Please indicate the type of estate planning service you are seeking (check all that apply):

Will Preparation

Trust Formation

Power of Attorney

Healthcare Directives

Asset Protection

Other (please specify): __________________________

Required

Who needs estate planning assistance?

You

Where are you located? (County and State) ______________________________

Someone else (please specify): _______________________

If someone else, where are they currently located? (County and State) _____________________

Both

Required

Do you have any existing estate planning documents already started or prepared?

Yes

if yes, Which ones? ____________________________________________

Required

Are you looking to contest any of these documents?

Yes

Required

How old are you?

Are you married?
*

Yes

Required

For how long?

Do you have children?

Yes

Required

How many?

What are their ages?

Do you own real property?

Yes

Required

In what state(s)?

Are you employed?
*

Yes

Required

What is your annual income?

Are you receiving Medicaid or Medicare?

Yes

Required

What is the value of your estate?

Do they have any special circumstances or needs? If yes, please describe:
*

Briefly describe your estate planning needs and the assistance you require:

Are you looking to hire an attorney?
*

Yes

Required

Have you previously worked with an estate planning attorney or consultancy?
*

Yes

Required

If yes, please provide the details of your previous attorney or consultancy and the outcome of your case:
*

Are you currently working with an attorney or consultant?

Yes

Required

Additional Information

How did you hear about our services?

Referral

Internet Search

Social Media

Other (please specify): __________________________

Required

Preferred appointment times:

Morning

Afternoon

Evening

Weekend

Required

Any other relevant information or special requests:

Closing:

Perfect, it seems like we should be able to help you with your case.

Could I set you up with an appointment with one of our attorneys and after review by attorney, a retainer packet for you to sign so we can get this process started?

Can I have your email address?

Finally, your preferred method of contact? Thank you. We will be in contact soon.

Cost: It depends on the difficulty of the case. After our one of our dedicated attorneys reviews your case, we will certainly send the cost of your investment.

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