Family Law Intake Form

Thank you for reaching out to Teixeira Law Office with your family law issue. In order for us to better assist with your inquiry, kindly complete the intake interview.

All related communications are confidential.

First & Middle Name

Last name

Phone

Address

Brief Summary of Issue

Birthday

Year

Month

Day

Birthplace

Former Spouse's Name

Is your former spouse Self-Represented?

Self-Represented

Has Counsel

Unsure

New Partner

Are you the Applicant or the Respondent?

Children ?

Children(s) Name, DOB - List all

Relationship Details

Separated - Living apart with intent to end relationship

Cohabitating - Still living together

N/A: Neither applies

Date of Marriage

Date of Separation

Legally Married?

Married: Legal marriage with certificate

Common Law: Living together as partners without formal marriage

N/A: Neither applies

Amicability - Briefly describe the state of your relationship, e.g. friendly, polite, tense, hostile, high conflict