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CONFIDENTIAL
Initial Consultation Questionnaire
UTAH

Today's Date*

PERSONAL INFORMATION

Your Full Name*

First Name

Middle Name (optional)

Last Name

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

If Address is Outside of the United States, Use This Area for Address Information

Your Birth Date*

Your Phone Number*

Your Email Address*

Your Employer*

Are You Active Military or a Veteran?*

Yes No

From time to time, important news and changes in the law may affect your legal and/or parental rights. Is it OK for us to send this and other important information to you?*

Yes No

How May We Send You This Valuable Information? REGULAR MAIL CORRESPONDENCE WILL BE SENT TO THE ADDRESS YOU HAVE INDICATED ABOVE.*

Email Regular Mail Both

Because we respect your privacy, we want to make sure it is OK to mail you at the address you have indicated on this form. Please confirm.*

Yes, you may send correspondence to the mailing address I have provided above.

WHAT IS YOUR CASE ABOUT?

Choose One*

Divorce Paternity (Not married with child/children) Protective Order Child Support Modification Other

If "Child Support," is ORS involved?

Yes No

If "Other," Please Explain*

OPPOSING PARTY INFORMATION

We will not contact the person you list below as "Opposing Party."
We simply need this information to ensure there are no conflicts of interest.

Opposing Party Name*

First Name

Last Name

Opposing Party Address

Address Line 1

Address Line 2

City

State

ZIP Code

If Address is Outside of the United States, Use This Area for Address Information

Opposing Party Birthdate

Opposing Party Phone Number

Opposing Party Email Address

Opposing Party Employer

IF YOUR CASE INVOLVES A CHILD/CHILDREN

Does Your Case Involve a Child/Children?*

Yes No

Where is/are the Child/Children Now?*

Please Provide the Name, Age and Birthdate for Each of Your Children*

CONFIDENTIAL
Initial Consultation Questionnaire
UTAH

PERSONAL INFORMATION

HOW DID YOU HEAR ABOUT US?

WHAT IS YOUR CASE ABOUT?

OPPOSING PARTY INFORMATION

IF YOUR CASE INVOLVES A CHILD/CHILDREN

CURRENT STATUS OF YOUR CASE

CONFIDENTIALInitial Consultation QuestionnaireUTAH

PERSONAL INFORMATION

HOW DID YOU HEAR ABOUT US?

WHAT IS YOUR CASE ABOUT?

OPPOSING PARTY INFORMATION

IF YOUR CASE INVOLVES A CHILD/CHILDREN

CURRENT STATUS OF YOUR CASE

CONFIDENTIAL
Initial Consultation Questionnaire
UTAH