Please fill out the following form in as much detail as possible so that we can perform our necessary conflicts check to determine whether we will be able to represent you or not. We will review all of the information provided and contact with you within 48 hours. If your matter is urgent, please send an email to tatiana@laracuentelaw.com.

*Note that this information is not protected under attorney-client privilege, and the submission of this form does not create such relationship. Please do not include sensitive information.

Privacy Policy

Our firm takes every step possible to protect your privacy. The data submitted via this form is encrypted and secured using industry-standard 256-bit SSL encryption.

If you have any questions, please don't hesitate to contact our law office. We look forward to working with you!

Contact information: Your Information

Prefix

First name *

Middle name

Last name *

Date of birth

Company

Emails

Address *

Type

Upon submission, a copy of this form will be sent to the primary email.

Add email

Addresses

Street address

Country

City

State/Region

Zip/Postal code

Address type

Add address

Phone numbers

Phone number

Type

Add phone number

THANK YOU

Thank you so much for completing this intake questionnaire. This information will be extremely helpful in evaluating your case. We will contact you as soon as possible with any updates.

Please click the SUBMIT button below when you have finished answering all questions.

Contact information: Your Information

Preferred Contact Method

Gender

What type of legal issue are you experience?

Briefly describe your legal issue and what resolution you are seeking.

Are you currently working with another attorney?

Marital Status

How were you referred to our law firm?

ACKNOWLEDGEMENT AND ACCEPTANCE

THANK YOU