Family Law Intake Form

Please take time to complete this form before we meet.  Please be as specific as you can.  The purpose of an initial consultation is for you to discuss your case with a family law attorney who is a Certified Family Law Specialist and obtain legal advice on your matter.

The fee for a 1-hour initial consultation is $750.  If your case involves complex issues such as custody and/or property division, we recommend scheduling 1 – 1.5 hours. Payment is required prior to the meeting.

If we decide to work together, we will enter into a written fee agreement, which spells out our responsibilities, and an advance retainer will be required. ($5,000 for limited scope/consulting attorney, and $15,000+ for traditional representation in litigation).

We reserve the right to decline representation after your initial consultation.

Rules for Consultation

1. Please do not bring your children to your consultation.
2. Please do not bring any third parties to your consultation unless you are aware that there will be no attorney/client privilege for the conversation that occurs. In other words, the consultation will no longer be private and can be discoverable in court.
3. If you do not use your entire consult time, I will allow a reasonable time, not to exceed 48 hours, to answer any follow-up questions via email.
4. Keep in mind that we have not been hired as your attorneys and we DO NOT represent you until there has been a signed written agreement after our initial consult. To protect your privacy, we shred your intake form if not retained within 48 hours, and do not keep copies.

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Name *

Email *

Phone Number *

Address *

Marital Status *

Do you have an attorney? *

• Yes
• No

Other Party's Name *

(Mandatory for Conflict Check)

Other Party's Counsel (If any) *

Is there a Court Case? *

• Yes
• No

Case Number

Date of Marriage

Date of Separation *

Information About Children *

(Please include names, ages, and date of births)

Do you have custody? *

What is your desired custody situation? *

Do you have plans to move out of the local area? *

Current Employment Situation *

(Please include name of employer, address, phone number, position, date started, and current salary.)

Other Party's Current Employment Situation *

(Please include name of employer, address, phone number, position, date started, and current salary.)

Current location and living situation for both (include sources of support). *

List All Known Community Property *

(For each item, indicate Description, Date of Acquisition, Present Location, Source and Nature of Consideration, Purchase Price, Current Fair Market Value and Encumbrances)

List All Your Separate Property *

(For each item, indicate Description, Date of Acquisition, Present Location, Source and Nature of Consideration, Purchase Price, Current Fair Market Value and Encumbrances)

List Other Party's Separate Property *

(For each item, indicate Description, Date of Acquisition, Present Location, Source and Nature of Consideration, Purchase Price, Current Fair Market Value and Encumbrances)

Do you have a prenuptial agreement/postnuptial agreement? *

• Yes
• No

Are there any challeges to these agreements? *

• Yes
• No

History of Violence? *

(please note our firm does not handle restraining orders – we will refer you if there is violence)

Current Relationship Status? *

• Amicable
• Contentious
• Both (please explain below)

Are there any issues you are concerned about? *

Would you like to consider marriage counseling or mediation? *

How did you hear about the Law and Mediation Offices of Kelly Chang? *

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