Civil Litigation Questionnaire

Disclaimer: Completing this form does not create any attorney-client relationship. Thus, no information provided by you shall be considered confidential or protected by an attorney-client confidentiality until our office is officially and adequately retained as your attorney and allowed a full opportunity to review for any conflict of interest.

 

Your First Name:
*

Your Last Name:
*

Company:

Name of Opposing Parties, Please list:

Name of Co-Defendants, Please list:

Have you been sued?:

Yes
No

If so, when were you served?:

What is the case number?:

Where is the place of dispute?
City: 


State: 

Court Location, if any:

Estimated amount in dispute or amount claimed:

Are you currently represented by an attorney?

Yes
No

Do you have a former attorney?

Yes
No

If you had a former attorney, what was your former attorney's name?

Please list the names of any former attorneys you have discussed this matter with:



Are you a plaintiff or a defendant?

Plaintiff
Defendant

If you are a plaintiff, what are your claims? If you are a Defendant, what are the claims that you/your company were sued for? (Please check all that apply):

Breach of Contract
Business and Partnership Dispute
Breach of Fiduciary Duty
Collections
Construction Defect
Contractor Licenses
Consumer Violation
Copyright & Patent
Defamation and Libel
Dog Bite
Employment
Declaratory Relief
Disabilities (ADA - Unruh)
Discrimination
Employment (Wage & Hour)
Employment (Overtime)
Employment (Sexual Harassment)
Employment (Wrongful Termination)
Employment (Discrimination)
Fraud
Medical Malpractice
Malpractice (Legal)
Personal Injury (Auto Accident)
Product Defect
Real Estate Related
Slip & Fall
Wrongful Death
Other

Please describe claims or causes of action not listed above:

Brief Comment on Case: (Disclose only non-confidential matters):

Do you have a copy of your Complaint?

Yes
No

Please provide a copy of your complaint (Only accepts .jpg, .jpeg, .png, .bmp):
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As discussed in your consultation agreement, Attorneys will not review documents in a consultation as that will require significant time and research. However, Attorneys may briefly review the complaint or pleadings in order to obtain a background to facilitate a meaningful evaluation and consultation.

I acknowledge that the foregoing information I am providing is solely for the purpose of having my case reviewed. I understand that the submission of this information does not form an attorney-client relationship. I certify that the information I have provided in this questionnaire is true to the best of my knowledge and belief.

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