The Bain Law Firm P.L.
Initial Client Consultation Interview Form
The purpose of an initial consultation is for the interviewing Attorney to advise you, the
prospective client what, if anything, may be done for you by our law firm, and what the minimum
fee for our services will be. The purpose is not to render a definitive legal opinion as it may
be impossible to fully assess a matter within the time frame allotted for a consultation or with the
information or documents that you may be able to provide at the initial consultation. Any
expression by the interviewing Attorney concerning your legal matter is an expression of
professional judgment, but is not a guarantee. Such opinions are necessarily limited by our
knowledge of the facts provided to us and are based on the state of the law at the time they are
One of three outcomes is possible following your consultation.
A. You and this law firm mutually agree to the terms of representation, or (After a separate
initial letter of representation is signed by you which encloses and incorporates by reference a
separate document called Standard Conditions Regarding Legal Representation which will be
provided to you and sets forth the terms of our representation.)
B. This law firm declines representation, or
C. You decide not to use the services of this law firm.
Work Telephone: (____) _______________
Home Telephone: (____) _______________
Fax: (____) _______________
Cell: (____) ________________
Briefly explain what you may need advice about or assistance with today:
Are there other parties involved? (Examples: a friend, an employer, a neighbor, a party to a
contract, etc. This should include all individuals and parties on either side of your issue.)
On the lines below, list the documents (papers) that you think may help us to understand
Ideally, if things turn out precisely the way you want, what would the outcome be?
Knowing that there are no guarantees, what can you accept to resolve this matter?
Please classify your urgency in concluding this matter. (Check One)
[ ] Critical- Personal safety or continuation of business depends on it.
[ ] Very important- severe hardship, personal or financial inconvenience if matter is not resolved
[ ] Important - Matter interferes with business or personal financial stability.
[ ] Needs to be done, but no immediate hardship in the interim.
[ ] Just thought I would see if it was worth pursuing at this time.
[ ] Just wanted to know what my rights are. I will then let you know after I think about it.
If the matter involves payment to you of money you believe you are owed, how long can you wait
before being paid?_______________________________(Days, Weeks, Months, Years)
Are we the first law firm or attorney you have consulted regarding this matter? [ ] Yes [ ] No If no,
please identify all such law firms and attorneys and indicate why you did not hire the other law
firms and/or attorneys:
Have you ever been represented by an attorney? [ ] Yes [ ] No If yes, please state the
Are you currently a party to a lawsuit or other legal proceedings? [ ] Yes [ ] No If yes, please
identify the lawsuit and legal proceedings, and nature of the issues: ______________________
Have you ever been a party to a legal proceeding, such as a lawsuit, criminal action,
administrative action, bankruptcy action, or arbitration proceeding? [ ] Yes [ ] No If yes, please
identify all such legal proceedings, including approximate dates and
Are you known by any other names? [ ] Yes [ ] No If yes, please list
name(s)_____________________________________________________ (a fictitious name,
a nickname, a former name, your maiden name, etc.)
Have you ever been convicted of a crime? [ ] Yes [ ] No If yes, please describe the crime, as
well as the date and location of conviction:__________________________________________
How will you pay for your attorney's fees and costs in connection with this matter? [ ] Check [ ]
Cash [ ]Contingency Fee [ ] On Account [ ]Other- Please describe:
Marital Status: [ ] Married [ ] Single [ ] Divorced [ ] Widowed [ ] Separated
Driver's License #___________________________ Social Security #_______-______-_______
Where are you employed?________________________________________________________
May we contact you there? [ ] Yes [ ] No Telephone No. ( ) __________________
If your mail is returned as undeliverable or your telephone service terminated, please provide the
name of someone (friend or relative) whom you believe will always know how to contact you.
Address_________________________________ Telephone No.: ( ) _________________
How did you learn of our office? [ ] A friend [ ] Bar Referral [ ] Attorney Referral [ ] Our
Web Page [ ] Other, please explain:
If referred to us, please identify the individual who referred you:
PLEASE READ CAREFULLY AND SIGN BELOW
Following your initial interview, if you agree to hire this law firm, and this law firm agrees to
represent you, you will be required to sign an initial letter of representation which will be provided
to you by the interviewing Attorney after your meeting along with a document entitled Standard
Conditions Regarding Legal Representation. The initial letter of representation and our Standard
Conditions Regarding Legal Representation will set for the terms and conditions of our
If the interviewing Attorney indicates that this law firm is willing to represent you and you decide
not to sign the initial letter of representation, you are strongly urged to immediately consult with
other legal counsel to protect your rights.
NOTICE: This law firm does not represent you with regard to the matters set forth
by you in this information sheet or discussed during your consultation with the
interviewing Attorney, unless and until, this law firm agrees to represent you and
you have signed and returned our written agreement for representation which is
embodied in our initial letter of representation(which incorporates and includes
the terms and conditions set forth in the Standard Conditions Regarding Legal
If the interviewing Attorney indicates that this law firm will not represent you, this includes not
representing you with regards to the matters set forth by you on this information sheet as well as
any other matters you may discuss with the interviewing Attorney during your consultation.
Please realize that there are strict time limitations within which you must act in order to protect
your rights. The time limits are complex and vary for different types of legal actions. Failure to
file a lawsuit or claim within the requisite time could result in you being barred forever from
pursuing your claims. Furthermore, failure to defend a legal action (i.e., lawsuit, etc.) or act within
the requisite time could result in an adverse judgment against you or you being barred in
the future from defending or asserting your rights. Therefore, the interviewing Attorney and this
law firm strongly urge you to immediately consult with another attorney to protect your rights. The
decision by the interviewing Attorney or this law firm not to represent you should not be taken by
you as an expression regarding the merits of your case. We are not expressing an opinion as to
whether or not you should take further legal action with regard to your legal matters. Our decision
to decline representation merely indicates only that we will not be representing you with respect
to such legal matters.
Your signature below acknowledges only that you received a copy of this completed
information sheet and does not mean that you have hired the interviewing Attorney or the
law firm to represent you.
Signature:_______________________________________ Date: ______________________