legal client intake form template word

Professional Legal Services Engagement Intake Form

Instructions for Use

• Complete all sections below accurately to ensure your legal team has the necessary information to perform conflict checks and initiate file opening procedures.
• Ensure that the individual signing this form has the requisite legal authority to bind the [Client Entity Name] to the terms of engagement.
• Once completed, return this document to your assigned attorney or the firm’s administrative office via secure encrypted transmission.

Parties and Definitions

This intake form serves as the preliminary record for legal services provided to: Client: [Full Legal Name/Entity Name] Address: [Street Address, City, State, Zip Code] Primary Contact: [Name of Authorized Representative] Matter Description: [Brief summary of the legal issue or project]

Operative Terms and Disclosures

1. Conflict of Interest: The Client acknowledges that the firm must conduct a conflict check before this intake is finalized. Completion of this form does not establish an attorney-client relationship until a formal engagement letter is signed by both parties.
2. Confidentiality: Information provided herein is protected by attorney-client privilege to the extent permitted by law. The firm agrees to maintain the confidentiality of all sensitive data disclosed during the intake process.
3. Accuracy of Information: The Client warrants that all information provided is true, accurate, and complete to the best of their knowledge. The Client agrees to notify the firm immediately of any material changes to this information.
4. Communication Preferences: The Client authorizes communication via:
   • Email: [Email Address]
   • Secure Portal: [Portal Name/URL]
   • Telephone: [Phone Number]
5. Document Retention: The firm will retain records in accordance with its internal document retention policy. Copies of all provided materials should be retained by the Client for their own records.
6. Billing and Fees: The Client acknowledges that a separate Fee Agreement will be provided outlining hourly rates, retainer requirements, and billing cycles.

Signature and Acknowledgment

By signing below, the undersigned represents that they are authorized to provide this information and initiate this legal inquiry.

Signature: __________ Printed Name: [Full Name] Title: [Job Title/Capacity] Date: [Date]

Legal Disclaimer: This document is a general framework intended for informational purposes only. It does not constitute legal advice. Laws regarding legal intake and attorney-client privilege vary by jurisdiction; consult with qualified counsel to ensure this document meets your specific regulatory and compliance requirements.