Client Questionnaire printable pdf download

CLIENT QUESTIONNAIRE

YOUR NAME:__________________________________ DATE:

In addition to securing a favorable ending to your criminal case, we want to make sure that the outcome

of your criminal case, to the extent possible, does not cause difficulties for you in any other part of your

life, like your job, your housing, or your education. For example, if you are not a citizen of the United

States, you can be removed from the U.S. for some convictions. Whether you are a citizen or not, you

can also lose your job, get evicted, have your parental rights terminated, or lose your educational benefits.

We want to avoid those problems to the extent possible. Please fill out this questionnaire. The more

information we have about you and your life, the easier it will be to try to avoid any problems in your life.

THE INFORMATION THAT YOU PROVIDE ON THIS FORM IS CONFIDENTIAL, AND IS

COVERED BY ATTORNEY-CLIENT PRIVILEGE.

CITIZENSHIP

If you are not a U.S. citizen, a criminal conviction could lead to your removal from the United

States.

THIS OFFICE DOES NOT HAVE EXPERTISE IN IMMIGRATION LAW.

YOU

SHOULD SEEK ADVICE FROM AN IMMIGRATION ATTORNEY BEFORE ACCEPTING

ANY RESOLUTION OF YOUR CRIMINAL CASE.

Are you a U.S. Citizen: yes ⁪; no ⁪

If you are not a U.S. Citizen:

What is your immigration status: _____________________________________________

________________________________________________________________________

How long have you been in the United States: __________________________________

Have you ever been removed from the U.S. or been refused admission at the border:

yes ⁪; no ⁪ ??? Ask Sejal

If yes, where and for what crimes: ____________________________________________

EMPLOYMENT:

Certain criminal convictions can prevent you from working in a particular job or from

getting/keeping an occupational license.

What kind of work do you do: _______________________________________________

How many people do you support with your income: _________No. of adults; _________No. of

children.

Client Questionnaire