Client Intake Questionnaire (Family Law)

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/Other Party Information

• Full legal name:
• Date of birth:
• Current address:
• Phone/email:
• Employer and occupation:
• Attorney (if known):

3. Matter Type

Select all that apply:
☐ Divorce / Dissolution
☐ Legal separation
☐ Child custody / parenting plan
☐ Child support
☐ Spousal support / alimony
☐ Paternity
☐ Modification / enforcement
☐ Domestic violence / protection order
☐ Adoption / guardianship
☐ Prenuptial / postnuptial agreement
☐ Other: ________________________

4. Relationship and Residency

• Date of marriage (if applicable):
• Date of separation:
• Current living arrangements:
• State of marriage:
• Residency in current state: [CLIENT] ___ years/months; [OTHER PARTY] ___ years/months
• Any prior filings or pending cases? ☐ Yes ☐ No
• If yes, court and case number:

5. Children

• Children of the relationship (names, DOB, current residence):
• Any children from other relationships involved in the case:
• Current custody/parenting schedule:
• School/daycare information:
• Special needs or medical issues:

6. Custody and Parenting Concerns

• Primary concerns (safety, relocation, visitation disputes, etc.):
• Proposed parenting plan:
• History of missed visits or interference:
• Substance abuse concerns: ☐ Yes ☐ No
• Domestic violence or abuse allegations: ☐ Yes ☐ No
• If yes, describe and dates:

7. Support (Child/Spousal)

• Current support orders (if any):
• Requested support changes:
• Health insurance for children: provider and cost:
• Childcare expenses:
• Extraordinary expenses (medical, educational, extracurricular):

8. Financial Information

• Client employer and income:
• Other party employer and income:
• Other income sources (bonuses, commissions, rental, investments):
• Monthly expenses (housing, utilities, transportation, insurance, medical, childcare):
• Tax filing status and recent returns available:

9. Assets and Debts

List all significant assets and liabilities:
- Real estate (addresses, approximate value, mortgage balance):
- Vehicles (make/model/year, value, loan):
- Bank accounts and retirement accounts:
- Business interests:
- Personal property (valuables, collectibles):
- Debts (credit cards, loans, tax debts):
- Separate vs. marital property claims:

10. Domestic Violence and Safety

• Protective orders in place or sought? ☐ Yes ☐ No
• Police reports or criminal cases? ☐ Yes ☐ No
• Safety concerns for client or children:
• Safe contact method and confidentiality needs:

11. Prior Counsel and Agreements

• Prior attorney consulted or retained? ☐ Yes ☐ No
• If yes, name and reason for change:
• Prenuptial/postnuptial agreement? ☐ Yes ☐ No
• If yes, provide copy:
• Mediation or collaborative law attempted? ☐ Yes ☐ No

12. Documents and Uploads

☐ Marriage certificate
☐ Any court orders or pleadings
☐ Tax returns (last 2-3 years)
☐ Pay stubs (last 2-3 months)
☐ Bank/retirement statements
☐ Mortgage/loan statements
☐ Prenuptial/postnuptial agreement
☐ Police reports / protective orders
☐ Child-related records (school, medical)
☐ Other supporting documents: ________________________

13. Goals and Priorities

• Primary objectives (custody, support, property division):
• Settlement goals:
• Litigation concerns:

14. 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: __________