client intake form google form

Prospective Client Engagement Intake Form

Instructions for Use

• Copy the content below into your preferred digital document editor (e.g., Google Docs, Microsoft Word) to create a template for your intake process.
• Replace all bracketed text [__________] with the specific details required for your firm’s administrative and conflict-checking procedures.
• Distribute this form to prospective clients via a secure link or print, ensuring all responses are stored in compliance with your local data privacy regulations.

Parties & Definitions

This Intake Form is provided by [Law Firm Name] ("Firm") to [Prospective Client Name] ("Client") for the purpose of evaluating a potential attorney-client relationship.

Client Contact Information: Full Legal Name: [] Entity Name (if applicable): [] Primary Email: [] Primary Phone: [] Mailing Address: [__________]

Operative Clauses

1. Purpose of Disclosure: The Client acknowledges that the information provided herein is for the sole purpose of enabling the Firm to conduct a conflict-of-interest check and to determine whether the Firm is able to provide legal representation.
2. No Attorney-Client Relationship: The submission of this form does not create an attorney-client relationship. Such a relationship is only established upon the mutual execution of a formal written Engagement Agreement signed by both the Firm and the Client.
3. Confidentiality: The Firm will treat the information provided as confidential to the extent required by applicable professional conduct rules, provided that the Firm may disclose this information to its internal personnel for the purpose of performing a conflict check.
4. Adverse Parties: The Client agrees to disclose all known adverse parties or entities involved in the potential matter: [__________].
5. Nature of Matter: Please provide a brief description of the legal services sought: [__________].
6. Urgency/Deadlines: Are there any known court-ordered deadlines or statutes of limitations? [ ] Yes - [ ] No If yes, please specify: [__________]
7. Documentation: The Client agrees to provide necessary documentation to support the evaluation of this matter upon the Firm's request.

Signature & Acknowledgment

By signing below, I certify that the information provided is accurate to the best of my knowledge and that I understand that this form does not constitute legal representation.

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

Legal Disclaimer: This document is a general framework intended for informational purposes only and does not constitute legal advice. You should consult with qualified counsel in your jurisdiction to ensure this form complies with local professional responsibility rules, data privacy laws, and conflict-of-interest regulations.