Thank you so much for contacting Freeman Law. Please read the privacy policy below, and then fill out this form in its entirety prior to our consultation. We will need this information to be able to fully evaluate your situation. If you are not sure if a document is needed, please provide it anyway. We would
much
rather review too many documents, than risk missing something important to your situation.
If you have any questions, or need help completing this form, please don't hesitate to contact our office. We look forward to working with you!
Privacy Policy
All information received from a client is strictly confidential. Our firm takes every step possible to protect your privacy. The data submitted via this form is encrypted and secured using industry-standard 256-bit SSL encryption.
Your Social Security Number and other personal information will only be used in the event that you hire the firm to represent you in your legal matter, and then only when necessary in limited use during the course of your case.
Social Security Numbers are most often used to positively identify parties. Most courts require Social Security Numbers of all parties in a case. Some other examples of how this information may be used include:
initial service
in court orders
in required reports or other documents filed with the State
Contact information
Prefix
First name
*
Middle name
Last name
*
Date of birth
Company
Emails
Address
*
Type
Upon submission, a copy of this form will be sent to the primary email.
Work
Home
Other
Primary
Default email false
Add email
Addresses
Street address
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Australia
Canada
United Kingdom
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---------------
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Panama
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Province/Region
Zip/Postal code
Address type
Work
Billing
Home
Other
Primary
Default address false
Add address
Phone numbers
Phone number
Type
Work
Home
Mobile
Fax
Pager
Skype
Other
Primary
Add phone number
Preferred Contact Method
Select an option
Email
Phone
No Preference
Date of Birth
Gender
Male
Female
Marital Status
Widowed
Former Spouse's Full Name
Single
Married
Spouse's Full Name
Separated
Spouse's Full Name
Divorced
Former Spouse's Full Name
Are you currently employed?
Yes
Employer Name
Job Title
Employer Phone Number
Employer Address
No
How were you referred to our law firm?
Friend or family member
Input the person's full name:
Another attorney
Input the attorney's full name:
Online search or lawyer directory website
Input the name of the website:
For example, "Avvo", "Facebook", or "LawFirmName.com"
Billboard, bus stop, phone book, newspaper, or other physical advertisement
Where was the ad located?
Radio or TV advertisement
What radio or TV station?
Bar Association
Which Bar Association?
Other
Please explain how you found us:
If our law firm ends up representing you in this matter, will you be the person who pays the legal fees?
Yes
How do you plan to pay?
Please indicate the source of funds or otherwise confirm that you have the ability to pay your legal fees.
No
Input the full name of the person who will pay the legal fees:
Input his/her phone number:
Input his/her email address:
Have you been served with a copy of the complaint?
Yes
When were you served with the complaint?
Who served you with the complaint?
Is the lawsuit in the Court of Common Pleas or the Magisterial District Court?
What is the docket number for the case?
Which company is suing you?
How much is being asked for in the complaint?
Do you believe that this account originated from identity theft or is otherwise fraudulent?
Please attach a copy of all of the paperwork that you received regarding this lawsuit.
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Are you the only party being sued? If not, who else is being sued?
If anyone else is being sued, please also include their relationship to you.
No
How did you learn about this lawsuit?
Have you received a notice to pick up the complaint from a sheriff or constable?
Not counting the debt that is the subject of this lawsuit, approximately how much other debt do you have for credit cards or medical bills?
This does not need to be precise. Your best estimate is fine.
ACKNOWLEDGEMENT AND ACCEPTANCE
I acknowledge that I have read and hereby accept the above privacy policy regarding use of my personal information.
THANK YOU
Thank you so much for completing this intake questionnaire. This information will be extremely helpful in evaluating your case. We will contact you as soon as possible with any updates.
Please click the
SUBMIT
button below when you have finished answering all questions.