client intake form template law firm

New Matter Intake and Conflict Check Form

Instructions for Use

• Complete all sections in full to ensure the firm can perform an accurate conflict of interest check before establishing an attorney-client relationship.
• Submit this document via secure encrypted channels only; do not include sensitive privileged information in unencrypted emails.
• Upon receipt, a member of our legal team will review the information and contact you regarding the next steps for formal engagement.

Parties & Definitions

Prospective Client: [Full Legal Name] Date of Birth: [] Contact Address: [Street Address, City, State, Zip] Primary Phone: [] Email Address: [__________] Opposing Parties/Adverse Entities: [List all individuals or entities potentially involved in this matter]

Numbered Operative Clauses

1. Nature of Representation: The Prospective Client is seeking legal assistance regarding the following matter: [Brief description of legal issue or case type].
2. Conflict of Interest Waiver: The Prospective Client acknowledges that the firm must perform a conflict check against current and former clients. The submission of this form does not create an attorney-client relationship.
3. Confidentiality: Information provided herein is treated as confidential to the extent permitted by law. However, the firm may disclose this information if required by court order or ethical obligations.
4. No Attorney-Client Relationship: No attorney-client relationship is formed until a formal Engagement Agreement is signed by both the firm and the client, and any required retainer fee is received.
5. Communication Preference: The Prospective Client authorizes the firm to contact them via:
   • Email
   • Phone
   • Secure Client Portal
6. Accuracy of Information: The Prospective Client warrants that all information provided in this form is true, accurate, and complete to the best of their knowledge.
7. Document Review: The Prospective Client acknowledges that the firm is under no obligation to review any documents submitted with this intake form unless specifically requested and agreed upon in writing.

Signature & Acknowledgment

By signing below, I certify that I have read the above terms and authorize the firm to conduct a preliminary conflict check.

Signature: __________ Printed Name: [] Title (if acting for an entity): [] Date: [__________]

Legal Disclaimer: This document is a general framework intended for informational purposes and does not constitute legal advice. Please consult with qualified counsel to ensure this form complies with your specific jurisdiction’s professional conduct rules and data privacy regulations.