Section 1: Personal Information

Preferred Method of Contact

Section 2: Legal Issue Description

Type of Legal Issue:

(e. g. , family law, estate planning, criminal defense, personal injury, etc.)

Brief Description of Your Legal Concern:

(Please provide a summary of the issue you are facing. Include key dates, events, and any other relevant details)

Have you consulted with another attorney regarding this matter?

Yes

If yes, please provide the attorney’s name:

No

Section 3: Relevant Deadlines

Are there any deadlines or court dates related to your issue?

Yes

If yes, please specify the dates and details:

No

Section 4: Conflict Check

Have you or any related parties been represented by Brunner Law, P.C. before?

Yes

If yes, please provide details:

No

Are there any individuals, businesses, or entities involved in your legal issue that you believe may have a connection to Brunner Law, P.C.?

Yes

If yes, please provide their names and details:

No

Section 5: Additional Information

Is there anything else you would like us to know about your legal issue?

Section 6: Acknowledgment and Disclaimer

I understand that completing this form does not establish an attorney-client relationship with Brunner Law, P.C. I also understand that the information I provide will be used solely for the purpose of evaluating my legal needs and determining whether Brunner Law, P.C. can assist me.

Yes

Signature (Typed Name):

Date:

THANK YOU