Thank you for contacting our law office! Please read the privacy policy below, and then fill out this form in its entirety prior to our consultation.

Privacy Policy

All information received from a client is strictly confidential. Our firm takes every step possible to protect your privacy. The data submitted via this form is encrypted and secured using industry-standard 256-bit SSL encryption.

Your personal information will only be used in the event that you hire the firm to represent you in your legal matter, and then only when necessary in limited use during the course of your case.

By opting into SMS from a web form or other medium, you are agreeing to receive SMS messages from LCD Law, PLLC. This includes SMS messages for appointment scheduling, appointment reminders, post-visit instructions, lab notifications, and billing notifications. Message frequency varies. Message and data rates may apply. See privacy policy at www.lcdlawfirm.com. Message HELP for help. Reply STOP to any message to opt out.

If you have any questions, please don't hesitate to contact our law office. We look forward to working with you!

Contact information: Please tell us a little about yourself.

Prefix

First name *

Middle name

Last name *

Date of birth

Emails

Address *

Type

Upon submission, a copy of this form will be sent to the primary email.

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Addresses

Street address

Country

City

State/Region

Zip/Postal code

Address type

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Phone numbers

Phone number

Type

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THANK YOU

Thank you for completing this intake questionnaire. This information will be extremely helpful in evaluating your case. We will contact you as soon as possible with any updates.

Please click the SUBMIT button below when you have finished answering all questions.

Contact information: Please tell us a little about yourself.

Preferred Contact Method

Gender

Are you currently employed?

If employed, what is your profession?

How were you referred to our law firm?

What is your branch of service?

Did you serve in the National Guard or Reserves?

What was your service entry date?

What was your service discharge date?

Please indicate your character of discharge

Do you have a Veterans disability rating?

Please provide information any relevant information about your service, including MOS, AFSC, rating, stateside locations, and deployments

Please provide any documents that you believe will help us better understand your case

Is there anything else we should know that has not already been covered?

Please acknowledge that you have read and hereby accept the above privacy policy regarding use of my personal information by typing your full legal name below

THANK YOU