JFCS Immigration Legal Services Online Intake

PLEASE NOTE:  Completing this form does NOT guarantee that your case will be accepted for representation by JFCS.  There is a waiting list and we will contact you when we reach your name on the list to schedule a consultation and discuss the particulars of your case. At that time, we will decide if we are able to accept your case and represent you. 

If you are already a client of JFCS for an immigration issue, please contact your attorney or representative directly.  If you have other questions about this form or the types of cases we accept, please call 412-904-5966.


We ARE currently accepting referrals for the following types of cases only:

  • Refugee/Asylee Green Card Applications

  • Family Reunification petitions (Refugees/Asylees)

  • Naturalization/Citizenship

  • Unaccompanied Children’s Issues

  • Afghan Nationals for SIV, Green Cards and TPS

  • TPS for all designated countries

  • Green Card Renewals

  • Employment Authorization Cards and Renewals

  • Central American Minors (CAM)

  • Human Trafficking, Victims of crimes and Violence Against Women’s Act cases

If you are a service provider sending a referral for someone else, please complete the form with the individual's information and add your contact info in the Referral section at the end.

If you have a case about anything else, please click here for a list of private attorneys and other non profit agencies who may be able to assist you.    

If you are looking for assistance with anything other than immigration legal services, you may visit ISAC Pittsburgh at https://isacpittsburgh.org/referral2019/ to complete their intake form.

The types of accepted cases may change from time to time, please feel free to check back in the future to see if we’re able to help you with other types of cases. 
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Email *
This section is about the person who needs immigration assistance
Legal First Name *
What is your legal first name?
Legal Last Name *
What is your legal last name?
Gender *
How do you identify?
Address Line 1 *
What is your street address? (Example: 5743 Bartlett St)
Address Line 2
What is your apartment, suite, or floor number? (Example: Apartment #29 or Floor 2)
City *
What is your city of residence? (Example: Pittsburgh)
State *
What is your state of residence? (Example: Pennsylvania)
Zip Code *
What is your zip code? (Example: 15217)
Primary Phone *
What is your primary phone number? (Example: 4124227200)
Secondary Phone
What is your secondary phone number? (Example: 4124227200)
Primary Email *
What is your primary email address? (Example: immigrationlegal@jfcspgh.org)
Marital Status *
What is your marital status?
English Level *
What is your English language level?
Country of Origin *
In which country were you born?
Languages *
Which languages do you speak?
Entry Visa *
How did you enter the United States?
Date of Entry *
On which date did you most recently enter the United States? If date is not known, please give your best estimate. DO NOT answer unknown.
Immigration Status *
What is your current immigration status?
Date of Birth *
What is your date of birth?
MM
/
DD
/
YYYY
A# / USCIS#
What is your Alien Registration Number? (You may find your A#/USCIS# on documents such as the I-94, Permanent Resident Card, Employment Authorization Document, and immigration court documents.)
Immigration Help *
What kind of immigration help do you need?
How many people are in your household? *
Are there people in your household (other than you) who require immigration assistance?  *
If there are other people in your household who need immigration assistance, please list below their names, dates of birth and A#'s as well as the type of immigration help they require. 
What is your annual household income? *
Criminal History *
Have you had any interaction with the police in the United States, or have you ever had to speak with a judge?
Required
Criminal History Description
If you answered "Yes" to the Criminal History question, then please explain. (Example: incident date, criminal charges, final outcomes, etc.)
Are there any additional services you need help with?
If you completed this form on behalf of someone else, please enter your information below.  If you completed the form for yourself, please skip the remaining questions. 
Referral Information
Name and email address of the person completing the form.
Referral Information
Phone number of the person completing the form
Referral Information
What is your relationship to the person who needs assistance?
A copy of your responses will be emailed to the address you provided.
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