New Client Form

Please complete this questionnaire as completely and accurately as you can.

All information that you provide will be held in strict confidence.

Legal First Name

Legal Middle Name

Legal Last Name

Other names used in the past

Current Address

Mailing Address if Different Than Above

Home Phone

Cell Phone

Work Phone

By providing me email address I authorize McDuffy Law Firm, PLLC may send me emails concerning my case.

What is the reason for your appointment?

PLEASE ACKNOWLEDGE THE FOLLOWING IMPORTANT STATEMENTS & SIGN BELOW:

I have completed this form as fully and accurately as possible and have not knowingly provided any false statements.

I understand that my initial consultation or strategy session fee is due at the end of the appointment unless other arrangements are made prior to my session.

Signature

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