Thomas Law Firm Client Intake Form

Thank you for trusting Thomas Law Firm with your legal needs. Please take the time to fill out this form completely. If the question does not apply, please type "Not Applicable"

CONFIDENTIALITY: The information you enter in this questionnaire is confidential and protected by Attorney-Client Privilege. The information will not be disclosed to anyone outside of this office, except in the course of rendering legal services on your behalf or as otherwise provided by law.

Your Information

Legal First Name

Middle Name

Legal Last Name

Name you would like us to use to address you

Social Security Number

Address

How long have you lived at this address?

List any previous residences in the past five (5) years and dates resided in each:

Primary Phone Number

Alternative Phone Number

Date of Birth

State of Birth

Driver's License Number

Are you currently employed?

Yes

Do you have a Will?

Yes