Client Intake Form

If you have any questions about this form, please give us a call at the number below.

Lazar Law

512-477-1600

Client Intake Form

About You

Name

Middle Initial

Last

Phone

Date of Birth

Place of Birth

Type of Case?

How do you plan to pay for your legal fees?

Address

City

State

Zip Code

Your Employer

Income

Approximate household net worth?

Last 3 digits of your Driver’s License number

Last 3 digits of your SS number

About the Opposing Party

Name

Middle Initial

Last

Phone

Date of Birth

Place of Birth

Address

City

State

Zip Code

Employer Address

Amount of Income

Concerning Children Involved

Child 1

Name of Child

Sex of Child

DOB of Child

Place of Birth of Child

Child 2

Name of Child

Sex of Child

DOB of Child

Place of Birth of Child

Child 3

Name of Child

Sex of Child

DOB of Child

Place of Birth of Child

Child 4

Name of Child

Sex of Child

DOB of Child

Place of Birth of Child

Child 5

Name of Child

Sex of Child

DOB of Child

Place of Birth of Child

General Child Information

County Where Children Reside

How Long?

Who Provides Healthcare for Children?

Name of Healthcare Provider

Do You or Other Parent Have Any Other Children?

About Your Marriage

Marital Status

Date Married

If Separated, Date of Separation

How Long Have You Lived in Texas?

Do You Want a Name Change?

Please State Your Full Requested Name

Place of Marriage

Summary and Referrals

General Reasons for Your Marital Difficulties or Summary of Your Situation

How Were You Referred to this Office?

Accepting Terms of Agreement

I understand the attorney is not retained unless I reach an agreement with the attorney regarding attorney fees and sign a separate written contract.

Select *

The consultation fee is due at the end of the consultation and I agree that my credit card can be used to pay the consultation fee. If I do not hire the attorney and sign a contract, there is no obligation for either myself or the attorney beyond the consultation today other than the payment of the consultation fee.

Select *

Please enter your full legal name showing your acceptance and agreement to the conditions stated above.

Digital Signature *

If you are human, leave this field blank.

OUR AREAS OF PRACTICE

DIVORCE

POSSESSION & ACCESS

COLLABORATIVE LAW

Jodi and her team were beyond thorough, respectful, and diligent. Let alone being a complete joy to work with, Jodi and the team really had my best interests at heart and it showed with every step they made. I owe my future to them and would recommend working with Lazar law to anyone.

– Frances G.

Lazar Law

512-477-1600

About You

About the Opposing Party

Concerning Children Involved

About Your Marriage

Summary and Referrals

Accepting Terms of Agreement

OUR AREAS OF PRACTICE

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512-477-1600

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Jodi Lazar