client intake form template word free download

New Client Intake and Engagement Questionnaire

Instructions for Use

• Complete all sections of this form accurately to ensure your legal team has the necessary information to open your file and identify potential conflicts of interest.
• Once completed, sign and date the document at the bottom and return it via secure transmission to your designated firm representative.
• Ensure that any secondary parties or corporate representatives listed have the legal authority to bind the entities mentioned in this document.

Parties & Definitions

This Intake Form is submitted by [Full Legal Name/Entity Name] ("Client") to [Law Firm Name] ("Counsel") for the purpose of initiating a professional legal relationship.

Client Contact Information: Address: [Street Address, City, State, Zip Code] Primary Phone: [] Email Address: [] Entity Type (if applicable): [ ] Individual [ ] Corporation [ ] LLC [ ] Partnership [ ] Other: [__________]

Operative Terms

1. Scope of Representation: The Client seeks legal services regarding the following matter: [Briefly describe the legal issue, transaction, or dispute].
2. Conflict of Interest Disclosure: The Client represents that, to the best of their knowledge, the following individuals or entities are opposing parties or have a material interest in this matter: [List all relevant names or state "None"].
3. Confidentiality: Information provided in this form is intended for the purpose of seeking legal advice and is protected by attorney-client privilege, subject to the firm's formal conflict check process.
4. No Attorney-Client Relationship: Completion of this form does not create an attorney-client relationship. Such a relationship is only established upon the execution of a formal Engagement Letter and payment of any required retainer.
5. Accuracy of Information: The Client warrants that all information provided herein is true, accurate, and complete to the best of their knowledge.
6. Electronic Communication: The Client consents to the use of unencrypted email for communications unless otherwise requested in writing.

Signature & Acknowledgment

By signing below, the Client acknowledges that they have read the terms above and authorize [Law Firm Name] to conduct a preliminary conflict check based on the information provided.

Signature: __________ Printed Name: [] Title (if Entity): [] Date: [__________]

Legal Disclaimer: This document is a general framework provided for informational purposes only. It does not constitute legal advice. Laws regarding attorney-client privilege, conflict disclosures, and client intake vary by jurisdiction. You must consult with qualified legal counsel in your specific jurisdiction to ensure this document complies with local bar association rules and statutory requirements.