client intake form description

New Client Information and Engagement Intake Form

Instructions for Use

• Complete all fields marked with [__________] to ensure your legal team has accurate contact and entity information.
• Review the operative clauses regarding confidentiality and conflict checks before signing to ensure mutual understanding of the intake process.
• Submit the signed original to your primary point of contact at the firm via secure portal or encrypted email.

I. Parties and Definitions

This form is entered into by and between [Full Legal Name of Client] ("Client") and [Law Firm Name] ("Firm").

Client Contact Information:

• Primary Contact Name: [__________]
• Entity/Company Name: [__________]
• Physical Address: [__________]
• Email Address: [__________]
• Phone Number: [__________]

II. Operative Terms

1. Purpose of Disclosure: The Client is providing the information herein for the sole purpose of enabling the Firm to conduct a conflict-of-interest check and to determine whether the Firm can provide legal representation to the Client.
2. No Attorney-Client Relationship: The completion and submission of this form does not create an attorney-client relationship. Such a relationship shall only be formed upon the execution of a formal, written Engagement Letter signed by both the Client and an authorized representative of the Firm.
3. Confidentiality: The Firm agrees to maintain the confidentiality of the information provided in this form to the extent required by applicable professional conduct rules, provided that the Firm may disclose such information as necessary to perform a conflict check.
4. Accuracy of Information: The Client represents and warrants that all information provided in this document is true, accurate, and complete to the best of their knowledge.
5. Conflict Check: The Client acknowledges that the Firm represents many other clients and that the Firm must perform a conflict check before accepting any new matter. The Client understands that the Firm may be required to decline representation if a conflict is discovered.
6. Matter Description: Please provide a brief summary of the legal matter for which you are seeking representation: [] []

III. Acknowledgment and Signature

By signing below, the undersigned acknowledges that they have read and understood the terms of this intake process.

Signature: __________ Printed Name: [] Title: [] Date: [__________]

IV. Legal Disclaimer

This document is a general framework intended for informational purposes only. It does not constitute legal advice. Laws regarding attorney-client privilege, intake procedures, and client identification vary by jurisdiction. You should consult with qualified legal counsel in your specific jurisdiction to ensure this document complies with all local professional conduct rules and statutory requirements.