Client Interview Info Form

CLIENT INTERVIEW INFO FORM (INDIVIDUALS) 1. Name 2. Home address 3. Business address 4. Address where attorney's billings should be sent 5. Telephone numbers Home Work (days and hours) Secretary's name and telephone number Telecopier or fax number Car telephone number Best telephone number for messages 6. Employer 7. Occupation 8. Date and place of birth 9. Driver's license number 10. Social security number 11. United States citizen? ____ (If not, state immigration status) 12. Spouse's name Date of birth Date of marriage Address, if different Work address Home telephone number, if different Work telephone number (days and hours) 13. Insurance information (if relevant) Name of insurance agent Home insurance coverage Vehicle insurance coverage Medical insurance coverage Other 14. Have you ever consulted another lawyer about this case? If so, name 15. Have you been served with any papers concerning this case? Describe briefly 16. Do you have any documents relating to this case (e.g., correspondence, invoices)? Describe 17. Where are your files or papers relating to this case? 18. Are you aware of any witnesses or people with knowledge of the facts of this case? Identify 19. Have you made any statements to anyone concerning this case? To whom/when/what 20. Referred by