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Civil Lawsuit Defense Intake Form

Date: ____________________________

Personal Information

Full Name: ______________________________________________________________

Date of Birth: __________________________

Phone Number: __________________________

Email Address: __________________________

Home Address: __________________________________________________________

Preferred Method of Contact (Phone/Email): _______________________________


Case Details

  1. Are you the defendant in a lawsuit? (Yes/No) ___________________________
  2. What is the nature of the lawsuit? (e.g., breach of contract, personal injury, property dispute, etc.) __________________________
  3. Who is the plaintiff? __________________________________________________
  4. Case Number (if applicable): ____________________________________________
  5. Court Name and Jurisdiction: ___________________________________________
  6. When were you served with legal papers? _______________________________
  7. Have you filed a response? (Yes/No) ___________________________________
  8. Deadline to respond or appear in court: ________________________________
  9. Briefly describe the allegations against you:
  10. Do you have any relevant documents? (e.g., contracts, correspondence, notices) (Yes/No)If yes, please list or describe:

Legal History

  1. Have you been involved in legal proceedings before? (Yes/No) ____________If yes, please provide details:
  2. Have you ever been represented by an attorney before? (Yes/No) ________
  3. Are there other parties involved in the case? (e.g., co-defendants) (Yes/No)If yes, please provide names and roles:
  4. Have there been any settlement discussions? (Yes/No)If yes, please summarize:

Goals and Expectations

  1. What is your primary objective in defending this case?
  2. What outcome are you hoping to achieve?
  3. Do you have any concerns about the case or legal process?

Financial Information

  1. Have you budgeted for legal representation? (Yes/No)
  2. Do you have legal insurance coverage? (Yes/No)If yes, please provide details:
  3. Are you interested in discussing payment plans? (Yes/No)

Additional Information

  1. Is there anything else we should know about the case or your circumstances?
  2. How did you hear about our law firm?

Acknowledgment

I acknowledge that completing this intake form does not establish an attorney-client relationship. The information provided is for evaluation purposes only and will remain confidential.

Signature: ____________________________

Date: ____________________________

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