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Name *

First Name

Last Name

Phone *

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Type of issue *

Family Law

Something Else

If this is a family law issue do you have a child(ren) under the age of 18? *

Yes

No

Not a family law issue

Is this a new issue or have you already been to court regarding this? *

Example: If you already have a custody/placement agreement and you want to modify please select "I have already been to court about this"

I have not been to court about this

I have already been to court about this

I understand that filling out this form does NOT, in itself, create an attorney-client relationship. *

Yes, I understand.