Family Law Intake Form

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Name Please enter your name.

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Are you known by other names? I am known by other names.

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If you are or have been known by other names, list them here. Please list other names you are or have been known by.

What is your marital status? Please indicate your marital status. Select status Single Married Divorced Separated Widowed

Does this matter involves a business you own or run? This matter involves a business I own or run.

This matter does not involves a business I own or run.

If this matter involves a business you own or run, list the business name, address and contact number. Please list the business name, address and contact number.

If a business is involved, how is the business organized? Please indicate how the business is organized. Select organization Sole Proprietorship Partnership Limited Liability Company Limited Partnership Professional Corporation S Corporation C Corporation Other

What is your employment status? I am employed.

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If you are employed, list the business name, address, and contact number of your employer. Please list the business name, address and contact number of your employer.

Can you be contacted at work? I can be contacted at work.

I cannot be contacted at work.

Please indicate the area of law your situation involves. Please indicate the area of law your situation involves. Area of law Administrative Law Admiralty / Maritime Law Adoption Agriculture Law Alternative Dispute Resolution Animal Bites Antitrust & Trade Regulation Aviation Aviation & Mass Transit Accid. Banking / Finance Law Bankruptcy Law Business & Commercial Law Business Organizations Child Support Civil Rights Construction Law Consumer Protection Contracts Criminal Law Criminal Law / Federal Custody / Visitation Discrimination Divorce DUI / DWI Education Law Elder Law Employment Law / Employee Employment Law / Employer Energy Law Environmental Law Estate Planning Ethics/Professional Resp. General Franchising Government Agencies/Programs Govt. Contracts Health & Health Care Law Immigration / Naturalization Insurance Law Intellectual Property Law International Law Internet / Cyberspace Labor Law Landlord / Tenant Legal Malpractice Litigation / Appeals Medical Malpractice Law Military Law Motor Vehicle Accidents Nursing Home Patent Personal Injury Personal Injury / Defense Premises Liability Probate Estate Administration Products Liability Law Professional Malpractice Law Real Estate Law Science / Technology Law Securities Law Sexual Harassment Social Security / Disability State / Local / Municipal Law Taxation Law Toxic Substances Trademarks Traffic Violations Transportation Law Trusts Wills Workers' Compensation Law Wrongful Death Describe your situation, including any relevant dates. Please describe your situation, including any relevant dates.

How would you rate the urgency of your legal need? Please rate the urgency of your legal need. Select urgency Extremely Urgent Urgent Standard Informational Only

Are any other people involved? Other people are involved.

No other people are involved.

If this matter involves others, list their names, addresses and relationship to you, if any. Please list the names, addresses and relationship to you of the others involved in this situation.

Do you have any documents that may help explain your situation? I have documents that help explain this situation.

I do not have documents that help explain this situation.

If you have related documents, list their names and dates. Please list the names and dates of your related documents.

Are there other helpful documents that you do not have access to? There are other helpful documents that I do not have access to.

I am not aware of any other helpful documents.

If there are other helpful documents that you don't have access to, list their names and dates. Please list the names and dates of the other helpful documents you don't have access to.

Describe how this situation has impacted you. Please describe how this situation has impacted you.

Describe what you would like to happen to resolve this issue. Please describe what you would like to happen to resolve this issue. What is the outcome you desire?

Have other attorneys worked on this matter? Other attorneys have worked on this matter.

Other attorneys have not worked on this matter.

If other attorneys have worked on this matter, list their names, addresses and a description of their involvement. Please list the names, addresses and a description of the other attorneys' involvement in this matter.

Describe any special concerns. Please describe any special concerns.

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The use of the Internet or this form for communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Confidential or time-sensitive information should not be sent through this form.

Please verify that you have read the disclaimer. I have read the disclaimer.

The family law attorneys of The Murphy Law Group serve clients in Central Illinois, including the communities of Peoria, Pekin, East Peoria, Eureka, Bloomington, Dunlap, Chillicothe, Normal, Lewistown, Lacon, Galesburg, Havana, Tremont, Pontiac, Wyoming, Princeville and Canton, as well as the counties of Peoria County, McLean County, Tazewell County, Woodford County, Fulton County, Marshall County, Knox County and Stark County.

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