1Consultation Information

2Personal Information

3Employment, Education, Income

4Case Information

5Other Party

6Children

7Miscellaneous

Consultation Form

Notice: You are being sent this form to complete because you have a scheduled consultation with one of the attorneys at Stearns-Montgomery and Proctor (SMP). Although the information you provide will be held in strictest confidence, until you speak directly with one of SMP’s attorneys in person or over the phone, the attorney-client relationship is NOT established.

This form is also used for initiating your case should you decide to retain SMP’s services.

I give permission for a Stearns-Montgomery & Proctor attorney or support staff member to email me regarding my legal issues.(Required)

Yes

Please call the phone number (678)-384-8670 and someone will be happy to assist you.

Please select the location most convenient for your consultation with the SMP Attorney.(Required)

Marietta

Atlanta - Buckhead

Johns Creek

Alpharetta

Fayetteville

Gainesville

Savannah

Canton

Telephone / Video Conference

What times are most convenient for you to consult with an attorney? Check all that apply.

in the next 30 minutes

between 9-11 am, Monday-Friday

before 9 am, Monday-Friday

in the next 3 hours

between 11 am - 1 pm, Monday-Friday

after 6 pm, Monday-Friday

between 1-5 pm, Monday-Friday

weekends

Are there any court orders or agreements (e.g. pre-nuptial or post-nuptial) between you and the other party?

Yes

I understand a copy of all the prior court orders and/or any documents relating to the pre-nup or post-nuptial agreement should be provided to get the most value for the consultation with the attorney.

Yes

Have you ever filed or been party to any other case involving the same parties?

Yes

If yes, state the County, Court and Date of any and all previous actions filed involving you and the other party.

Is there a case pending with a Court?

Yes

What is the Civil Action File Number of the pending litigation?

Is there a court date scheduled? What is the date set for court?

Name(Required)

Prefix First Middle Last Suffix

Date of Birth(Required)

MM slash DD slash YYYY

Social Security Number(Required)

*Please include only the last four digits.

Physical Residence

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is your Physical address the same as your mailing address?(Required)

Yes

Mailing Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If you live in Georgia county do you reside?

If the other party resides in Georgia, in which county do they reside??

Do you rent or own your residence?

Rent

Own

What is the fair market value (estimate) of your residence?

Please enter a number greater than or equal to 0.

What is the total amount of debt associated with the residence?

Please enter a number greater than or equal to 0.

Are the parties involved residing in the same residence?

Yes

Is the residence jointly titled in your name and your spouses?

Yes

Unknown

Provide a brief description of your legal issue:

Telephone Numbers: Check preferred number where we may call or leave messages:

Home

Cell

Work

Cell(Required)

Home

Work

Email(Required)

Your Employer:

Occupation

Education (Grade & Degree):

Income / Earning Capacity

Are you a business owner or self employed?

Yes

Have you ever served in the Military?(Required)

Yes

Do you have any professional licenses?

Yes

Name of professional licenses

Have you ever filled for bankruptcy in the past?(Required)

Yes

If yes, what year?

Are Children Involved?(Required)

Yes

Nature of Legal Problem:

Custody

Contempt

Paternity

Modification

Legitimation

Visitation

Adoption by 3rd Party

Adoption by Step Parent

Adoption by Blood Relative

Termination Proceedings

Divorce of Parents

Grandparents Rights

Other

Nature of Legal Problem - Other

Contested issues to be addressed between the parties. Check all that apply:

Alimony

Automobile

Real Property

Attorney Fees

Medical Insurance

Life Insurance

Miscellaneous personal property Retirement Account

Non-marital/pre-marital assets

Child Custody / Visitation

Other

Contested Issue - Other

Is it your opinion that any action between you and the opposing party will be:

Low conflict

Medium conflict

High Conflict

Would you prefer an attorney (choose the one that most fits your requirements):

Very Aggressive

Composed, but stern and forceful when necessary

Peacemaker

What is the relative urgency?

Critical, personal safety or safety of children at issue

Very Important, legal rights and interests will be affected if action not taken

Important, matter is causing instability

Needs to be done, but no immediate hardship

Informational, to see if it is worth pursuing

Joint Account(s) Status (please state whether still open or closed):

Credit Card(s)

Open

Closed

Bank Account(s)

Open

Closed

Equity Line(s)

Open

Closed

Have you or the Other Party had a previous consultation with this office?

Yes

If yes, please explain:

If the other party has retained an attorney, please state his/her name:

Is an attorney currently representing you in this legal action?

Yes

If so, who is the attorney representing you?

Have you discussed your legal matter with another firm?

Yes

Other Party Name(Required)

Prefix First Middle Last Suffix

Other Party Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Other's Party Date of Birth

MM slash DD slash YYYY

Other Party's Social Security Number

*Please include only the last four digits.

Other Party's Phone Number

Other's Party Email Address

Employer

Occupation

Education (Grade & Degree)

Income / Earning Capacity

Do you know if the other party has any professional licenses?

Yes

Other Party Professional licenses

With regards to the other party’s residence, are you aware if the other party rents or owns?

Rents

Owns

Are you aware if the other party has ever filed for bankruptcy?

Yes

How would you prefer to serve the other party?

Request the other party acknowledge service – I believe the other party will be cooperative.

Sheriff Service – I believe the other party will NOT avoid service of the document.

Process Server - I believe the other party is likely to be uncooperative and avoid service.

Where would you prefer to serve the other party?

Home

Work/Office

Other

Is the other party currently or has ever served in the Military?

Yes

Is there a history of violence?

Yes

If yes, have there been any criminal charges filed?

Yes

Children

Child's Full Name	Date of Birth	Sex	Is the child currently residing with you?	What is your relationship to the minor child involved?	Actions

There are no Children.

Maximum number of children reached.

Why did you choose our law firm? Choose all that apply.

Referred

Used Previously

Reputation

Quality of Website

Size of Firm

Location

Other

Were you referred, and if so, what is the name of the attorney you were referred to?

May we thank the person who referred you

Yes

N/A

If convenient for you to do so, please provide the name and contact information of the person who referred you to SMP or one of SMP’s attorneys.

Other helpful information, including previously related cases

How will you pay your attorney fees?

It is important to complete the form in its entirety. A fully completed form will provide you with the most value for your scheduled consultation. It will enable your attorney to evaluate your legal needs with answers to potentially relevant questions, that may affect the advice given, while simultaneously allowing considerably more time to answer your immediate concerns.

Signature(Required)

Consultation Form

WARNING: You are being sent this form to complete because you have a scheduled consultation with one of the attorneys at Stearns-Montgomery and Proctor (SMP). Although the information you provide will be held in strictest confidence, until you speak directly with one of SMP’s attorneys in person or over the phone, the attorney-client relationship is NOT established.

This form is also used for initiating your case should you decide to retain SMP’s services.