Alps Sample Client Intake Form
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1NOTE: This material is intended as only an example which you may use in developing your own form. It is not
considered legal advice and as always, you will need to do your own research to make your own conclusions
with regard to the laws and ethical opinions of your jurisdiction. In no event will ALPS be liable for any direct,
indirect, or consequential damages resulting from the use of this material.
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Sample Client Intake Form
1. Client _______________________________________________
Date ______________________________
File No. ________________ Responsible Attorney _______________________________________________
2. Contact ________________________________________________________________________________
Address _____________________________________
Phone _______________________________
______________________________________
Fax _________________________________
______________________________________
Email ________________________________
3. Matter (for file tab) ________________________________________________________________________
Summary description of our work ____________________________________________________________
_________________________________________________________________________________________
4. Adverse Party (and Affiliates)
Opposing Counsel (Name & Address)
____________________________
____________________________________________________
____________________________
____________________________________________________
____________________________
____________________________________________________
____________________________
____________________________________________________
5. Assigned Attorney _______________________________
6. Fee Arrangements: Engagement Letter Sent? (___) Yes (___) No - Reason ___________________
Send Bill To:
Bill: (___) Monthly (___) Upon Completion
______________________________________ (Name)
(___) Retainer
$________________
______________________________________ (Address)
(___) Hourly
______________________________________
(___) Contingent
______________________________________
(___) Fixed Fee $________________
7. *Conflicts Check completed by _____________________________________
(*File can not be
*Conflicts Database updated by _____________________________________
opened if incomplete)
*New Client Memo circulated by ____________________________________
8. Calendaring File Review Frequency (___) 30 Days (___) 60 Days
If subject to a Statute of Limitations: Applicable Statute _____________________________________
S.O.L. Date _________________ *Verified by __________________________ (Attorney Initials)
9. Source of Business ___________________________________________________________________
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