Client Intake Questionnaire (Estate Planning)

1. Client Information

• Full legal name:
• Preferred name/pronouns:
• Date of birth:
• SSN/Tax ID (if needed):
• Residential address:
• Mailing address (if different):
• Primary phone:
• Alternate phone:
• Email address:
• Preferred communication method (phone/email/portal/text): Text messaging may not be confidential.

2. Spouse/Partner Information (if applicable)

• Full legal name:
• Date of birth:
• Citizenship status:
• Address (if different):
• Prior marriages and dates of divorce/death of spouse:

3. Family and Beneficiaries

• Children (names, DOB):
• Other dependents or relatives to provide for:
• Intended beneficiaries (individuals/charities):
• Special circumstances (minor children, special needs, estrangement):

4. Estate Planning Goals

• Primary goals (select all that apply):
• ☐ Will
• ☐ Revocable living trust
• ☐ Probate avoidance
• ☐ Tax planning
• ☐ Guardianship for minors
• ☐ Special needs planning
• ☐ Charitable giving
• ☐ Business succession
• ☐ Long-term care planning
• ☐ Other: ________________________

5. Existing Documents

• Prior will or trust? ☐ Yes ☐ No
• Powers of attorney (financial/health)? ☐ Yes ☐ No
• Advance directive/living will? ☐ Yes ☐ No
• Beneficiary designations reviewed recently? ☐ Yes ☐ No
• If yes, provide copies.

6. Assets (summary)

• Real estate (addresses, approximate value, ownership):
• Bank accounts (checking/savings):
• Retirement accounts (401(k), IRA):
• Life insurance policies:
• Investment accounts:
• Business interests:
• Vehicles/boats/other titled property:
• Digital assets/crypto:
• Other significant assets:

7. Debts and Obligations

• Mortgages:
• Loans/lines of credit:
• Credit card debt:
• Support obligations:
• Other liabilities:

8. Fiduciaries and Agents

• Desired executor/personal representative:
• Desired trustee(s):
• Desired guardian for minor children:
• Desired agent for financial POA:
• Desired health care proxy:
• Alternate choices if primary unavailable:

9. Health and Long-Term Care

• Significant health concerns:
• Long-term care insurance? ☐ Yes ☐ No
• Planning for incapacity priorities:

10. Business and Professional Interests

• Ownership interests (entity type, percentage):
• Operating agreements or buy-sell agreements:
• Succession preferences:

11. Charitable and Legacy Gifts

• Charities or causes to support:
• Specific bequests or legacy goals:

12. Documents to Provide

+☐ Prior estate planning documents
+☐ Recent financial statements
+☐ Deeds/titles
+☐ Insurance policies
+☐ Retirement account statements
+☐ Business agreements
+☐ List of debts and obligations
+☐ Other supporting documents: ________________________

13. Acknowledgment

• I certify that the information provided is accurate to the best of my knowledge and understand that submission does not create an attorney-client relationship until a written engagement agreement is signed.

Client signature: ____________________________ Date: __________

Intake received by (staff): ____________________ Date: __________