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Personal Injury Law
Business Law
Intellectual Property
Corporate Law
Criminal Law
Bankruptcy
DUI/DWI
Divorce and Family Law
Immigration
Real Estate Law
Social Security Disability
Tax Law
Wills, Trusts, Estates (Probate Law)
Why do you need an Intellectual Property Attorney?
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Copyright
Patents
Trademarks
Trade Secrets
Intellectual Property
I am seeking assistance for
Select an option
Getting a copyright
Enforcing a copyright against an infringer
Defending against a claim of infringement
Resolving a dispute about who owns the copyright
Licensing or assign a copyright
Other
Obtaining a patent
Avoiding any potential patent infringement as the product is designed
Suing someone else for patent infringement
Defending against a claim of patent infringement
Apply for a trademark or servicemark
Defend against a claim of trademark infringement
Prevent someone else from infringing my trademark
License someone else to use my trademark
Get a license to use someone else'strademark
Protect my trade secrets from being taken by another company or individual
Defend me against accusations of taking or leaking someone else's trade secrets
My dispute is with
Select an option
No dispute
Co-authors
My employee
The original author
An author whose work is derived from mine
Someone to whom I gave a copyright license
Someone who is copying my work
Other
What does your case concern?
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Agreements
Breach of Contract
Drafting Agreements
Business Disputes
Corps, LLCs, Partnerships, etc.
Buying or Selling a Business
Entertainment Law
Starting a Business
What is your budget for this matter?
$500
$500-2500
$2500
Why are you considering bankruptcy?
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Garnishment
Creditor Harassment
Repossession
Foreclosure
Lawsuits
Illness/Disability
License Suspension
Divorce
Loss of Income
Other
What is your annual income?
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$5,000-$25,000
$25,000-$45,000
$45,00-$65,000
$65,000-$100,000
Over $100,000
Unemployed
Estimated Monthly Expenses
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Less than $2,500
$2,500-$5,000
More than $5,000
Who is the accused party?
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Myself
Spouse
Parent
Minor Child
Other Relative/Friend
What is the crime being accused?
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Assault & Battery
Drug Crimes
Drunk Driving/DUI/DWI
Traffic Violations
White Collar Crimes
Theft/Burglary/Shoplifting
Other Felony
Other Misdemeanor
Have Charges Been Pressed
No
Yes
Is this a first offense?
No
Yes
Is someone currently in custody?
Select an option
Yes, awaiting bail hearing
Yes, awaiting trial or sentencing
Yes, already convicted
No, free on bail
No, formal charges not yet filed
Is this a first offense?
Yes
No
Are you wanting to challenge your suspension?
No
Yes
Reason you need your license?
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Job Requirement
Work Commute
School
Medical
Family Needs
Transporting Your Children
Other
Reason for Needing an Employment Lawyer:
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Disabilities
Employment Contracts
Employment Discrimination
Pensions and Benefits
Sexual Harassment
Unpaid Wages
Wages and Overtime Pay
Workplace Disputes
Wrongful Termination
I am an:
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Employee
Independent Contractor
Employer
Other
Name of Company
Industry
Select an option
High technology
Retail
Professional (law, accounting, architecture, etc.)
Construction
Education
Government
Manufacturing
Transportation
Other
Has a formal Complaint been filed?
--
Yes
No
Date of Hire
No
Yes
Why do you need a family lawyer?
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Adoptions
Child Custody and Visitation
Child Support
Divorce
Guardianship
Paternity
Separations
Spousal Support or Alimony
The status of our relationship is
Select an option
We are living together but not married
We are not living together and never have been married
We are married and living together
We are separated and have not yet filed for divorce
We are separated and a divorce case has been filed
We are divorced and both living alone
We are divorced and I am now married to someone else
We are divorced and my ex-spouse is now married to someone else
We are divorced and we both are now married to others
Other
Are you attempting to reconcile?
No
Yes
Are there children involved?
No
Yes
Would you consider a family lawyer mediator?
Select an option
Yes, we would
Yes, I would, but I'm not sure about my spouse
Yes, I would, but my spouse will not
No
I'm not sure what mediation is
What is your annual income?
Select an option
$5,000-$25,000
$25,000-$45,000
$45,00-$65,000
$65,000-$100,000
Over $100,000
Unemployed
What is your spouse's annual income?
Select an option
$5,000-$25,000
$25,000-$45,000
$45,00-$65,000
$65,000-$100,000
Over $100,000
Unemployed
Reason for needing an Immigration Lawyer
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Citizenship
Removal or Deportation
Permanent Visas or Green Cards
Temporary Visas
The person with the immigration matter is
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Not within the United States
In the United States on a Visa
In the United States without proper documentation
In deportation proceedings
Other
Does person involved require a translator?
No
Yes
If yes, what language?
The person is seeking a temporary visa for:
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Work
School / education
Tourism
Business
Fiancee
Visiting family members
Other
Injury Date
What state did the injury occur in?
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
What is the cause of the injury?
Select an option
18 Wheeler Accident
Admirality/Maritime Accident
Birth Injury
Bus, Train Common Carrier Accident
Boating/Jet Ski Accident
Bicycle, Bike, Motorcycle Accident
Car, Truck, SUV, Accident
Construction Accident
Defective Drug
Defective Product
Dog Bite
Industrial Accident
Medical Malpractice
Mesothelioma
Nursing Home Neglect
Pedestrian Accident
Police Brutality
Sexual Abuse, Harassment
Slip and Fall
Toxic Chemicals
Wrongful Death
Work Accident
Other
Which of the following does this case pertain to?
Select an option
Avaulta Pelvic Mesh
Denture cream
DePuy Hip Replacement
Medtronic INFUSE Bone Graft (BMP-2)
Pelvic mesh
Zimmer NexGen Knee Replacement
Other: (list below)
Other
Which of the following does this case pertain to?
Select an option
Actos
Accutane
Aredia
Ambien
Avandia
Avastin
Balacet
Bextra
Boniva
Byetta
Celexa
Chantix
Clomid
Crestor
Darvocet
Darvon
Didronel
Diflucan
Dilantin
Effexor
Fentanyl
Fosamax
Gad
Gentamicin
Levaquin
Lexapro
Lunesta
NuvaRing
Paxil
Paxil SSRI
Pradaxa
Pristiq
Propacet 100
Propecia
Propoxyphene
Prozac
Prozac SSRI
Reclast
Reglan
Skelid
SSRI-Autism
Tekturna
Topamax
Trasylol
Tylenol
YAZ
Zocor
Zoloft
Zoloft SSRI
Zometa
Other: (list below)
What is your age?
Date you started taking drug? MM/DD/YY
Date you stopped taking drug? MM/DD/YY
Please list your side effects
Other
Name of Employer
What is your Job Title?
Was the injury reported?
No
Yes
Have you received medical treatment?
No
Yes
Do you have a copy of the police report?
No
Yes
Extent of damage to vehicle
Select an option
No damage
Minor scratches or bumps
Major structural damage
The vehicle is totaled/Likely not repairable
I don't know
Other
Other
Other
Does this case involve bodily injury or death?
Yes
No
What type of injuries were sustained?
Cuts & Bruises
Whiplash
Broken bones
Lost limb
Spinal cord injury
Paralysis
Loss of life
Stroke/Heart Attack
Brain injury
Electrocution
Burn
Other
Estimated medical bills
Select an option
Less than $1,000
$1,000 - $5,000
$5,000 - $10,000
$10,000 - $25,000
$25,000 - $100,000
More than $100,000
Don't Know
No Medical Bills
What kind of real estate issue is this?
Select an option
Real Estate Disputes
Landlord Tenant Disputes
Residential Rental Agreements
Commercial Lease Agreements
Legal Home Inspection
Joint Ownership & Shared Ownership
California 1031 Exchanges
Land Use & Variances
Breach of Real Estate Contract
Misrepresentation of Real Estate
Boundary Dispute, Fences & Encroachments
Adjoining Landowner Disputes
Drainage Disputes
Tree Disputes
Partnership & Joint Venture Disputes
Quiet Title Actions
Specific Performance
Construction Litigation
Claims & Defenses in ConstructionLitigation
Bankruptcy & Creditor's Rights
Other
Are you buying a home?
No
Yes
Does this concern a foreclosure?
No
Yes
Date of Birth
What health condition prevents you from working?
Will you be out of work for at least 12 months?
No
Yes
Have you applied in the past 18 months?
No
Yes
Has your claim been denied?
No
Yes
Is this matter for a business?
No
Yes
Reason needing tax legal assistance
Select an option
Consultation / advice
Tax preparation
Audit
IRS Hearing
Not a business matter
Other
My Business Is
Select an option
Privately held
Publicly traded
Nonprofit
Not a business matter
Other
Do you owe the IRS back taxes?
No
Yes
I need legal assistance to negotiate with the IRS
Select an option
An offer in compromise
Tax penalties removed
An installment payment agreement
Tax liens and levies stopped
The criminal investigation stopped
No negotiations with the IRS
Other
Why are you seeking legal help?
Select an option
Business interests
Life insurance policies
Personal Possessions
Stocks/Bonds
Cash
Pensions/Retirement
Property
Other
What assets are involved?
Select an option
Business interests
Life insurance policies
Personal Possessions
Stocks/Bonds
Cash
Pensions/Retirement
Property
Other
Total amount of assets?
Select an option
Business interests
Life insurance policies
Personal Possessions
Stocks/Bonds
Cash
Pensions/Retirement
Property
Other
Is an attorney currently representing you?
No
Yes
Please briefly describe your case in 200 words
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