Family Law Client Intake Form

Your information

Name *

Birth date

Address line 1

Address line 2

Cell phone *

Home phone

Business phone

Email address *

Please specify

Other party’s information

Name *

Birth date

Address line 1

Address line 2

Home phone

Cell phone

Work phone

Email address

Occupation

Approximate annual income

Country of residence

Surname at birth

Surname immediately before marriage

Children

Are there children from this marriage/relationship?

Name

Birth date

Lives with

Name

Birth date

Lives with

Name

Birth date

Lives with

Name

Birth date

Lives with

Are there children from any other relationship?

Name

Birth date

Lives with

Name

Birth date

Lives with

Name

Birth date

Lives with

Name

Birth date

Lives with

Other details

Who made the decision to end the relationship?

Do you have an interest in reconciliation with this person?

Yes

No

Tell us one positive thing about the other party

Please provide a brief history of your marriage/relationship

Please specify

Issue(s) in dispute (select all that apply):

Parenting responsibilities (guardianship)

Why is this important to you?

Parenting time (schedule)

Why is this important to you?

Contact with others

Why is this important to you?

Child support

Why is this important to you?

Section 7 expenses (activities, daycare, etc.)

Why is this important to you?

Spousal support

Why is this important to you?

Property division

Why is this important to you?

Financial disclosure

Why is this important to you?

Other

Please specify

Why is this important to you?

Have you been to court on this file?

Yes

No

What level of court? (Select all that apply.)

Provincial Court

Superior Court

Is there an application before the court?

Yes

No

What were the issues in dispute?

Was a court order entered?

Yes

No

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Your information

Other party’s information

Children

Other details

Overview

Business info