Initial Client Consultation Interview by cwj21439

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									                 Law Office of Rachel M. Baird

            Initial Client Consultation Form
Scheduled Client Appointment (Call (860) 626-9991 or (866) 279-6402)
Date:
Time:
Location:

The use of this form does not constitute the acceptance of any case by Attorney Rachel M.
Baird. A prospective client has retained Attorney Baird only after a written attorney-client
agreement has been signed and executed by both Attorney Baird and the prospective client.
Any information provided in this form or at an initial consultation with Attorney Baird is part
of the prospective client’s initial consultation. Responses are protected by the attorney-client
privilege and will be held in strict confidence.

Name:           __________________________________________________________________
                First                   Middle                  Last

Address:        __________________________________________________________________
                Number      Street      (Apt. No.)

                __________________________________________________________________
                City or Town            State       Zip Code

Home Phone #:         ____________________________________________________________

Cell Phone #:         ____________________________________________________________

Email Address:        ____________________________________________________________

Has a lawsuit or other charge been filed against you? ________ If so, bring a copy of the suit,
or charge, and all attachments. When and how were you served with the suit? ______________
______________________________________________________________________________

Have you been arrested? ________ If so, bring a copy of any documents related to the arrest.
When and how were you arrested? ________________________________________________
______________________________________________________________________________




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Re: ___________________________
    Your Name
Briefly describe the nature of your need for the services of an attorney:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________ (continue on back, if needed)

Identify Individuals/Businesses/Government Agencies that are involved in your case and/or have
information about your case:
1.      ________________________________________________________________________
        ________________________________________________________________________
2.      ________________________________________________________________________
        ________________________________________________________________________
3.      ________________________________________________________________________
        ________________________________________________________________________

List Documents that you have or know of related to your case:
1.     ________________________________________________________________________
       ________________________________________________________________________
2.     ________________________________________________________________________
       ________________________________________________________________________
3.     ________________________________________________________________________
       ________________________________________________________________________

Your Occupation:       ____________________________________________________________

Name of Employer:      ____________________________________________________________

Length of Time in Present Employment: ____________________________________________

General Educational Background:       ________________________________________________

______________________________________________________________________________




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Re: ___________________________
    Your Name
Please provide the name of someone (friend or relative) who may be contacted if Attorney Baird
is unable to reach you:
Name:       _________________________________              Phone #: (____)________________

Relationship: __________________________________________________________________

Address       __________________________________________________________________
              Number       Street     (Apt. No.)
              __________________________________________________________________
              City or Town            State       Zip Code

Additional areas of concern or other information not requested in this form related to your case:
1. ___________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
2. ___________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
3. ___________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
4. ___________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
5. ___________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

How did you learn about Attorney Baird’s law office?
[ ]   A Friend
[ ]   A Relative
[ ]   Newspaper/Media
[ ]   A Work Colleague or Acquaintance
[ ]   Yellow Pages
[ ]   Professional Association Referral
[ ]   Attorney Baird’s Web Page
[ ]   Other: __________________________________________________________

Notes:




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