HMBCR Intake Contact Request Form

Please complete the following information as completely as possible and include the names of any known adverse parties.

DO NOT PROVIDE CONFIDENTIAL INFORMATION.

By using this Contact Request Form you understand and agree that an attorney-client relationship is not formed by this submission and that our firm has the right to decline representation of you, in our sole discretion, upon our review of your submission.

In your description below, please describe the nature and reason for your inquiry.

Example of a GOOD inquiry description: "My friend, 'Tuck,' is a Franciscan Friar. He and I have a business together we call Tuck and Bargains. We buy items from garage sales and resell them on-line through e-LoadingDock. We'd like to talk to an attorney about the process of registering our business as an LLC."

Do NOT send an inquiry description like this: "My friend, Tuck, and I steal from the rich and give to the poor. Tuck was arrested last week for a theft I committed."

* indicates a required field.

Please allow up to two business days for contact request processing.

Name of Prospective Client

Contact Name (if different than Prospective Client)

Preferred Method of Contact*

Contact Email Address

Contact Phone Number

INQUIRY DESCRIPTION: Brief description of the purpose of your inquiry. Be sure to identify the names of any adverse parties to allow us to perform a conflicts check. (DO NOT INCLUDE CONFIDENTIAL INFORMATION)

Pending Deadline (if applicable)

Earliest Pending Deadline is for (if not applicable enter "None"):

By submitting this Contact Request Form you understand and agree that an attorney-client relationship is not formed hereby; that our firm reserves the right to decline representation of the prospective client identified herein, at our sole discretion, for any or no reason; and that no information you have provided in this form is privileged information or otherwise confidential in any way.*