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Family Law Intake Form

Please complete the information below as best as you can. All fields marked with * are required and must be filled.

First name*

Last name*

Email*

Phone*

Do you text?*

Is it ok to leave a message?

Primary language*

Do you need an interpreter?*

If yes, which language?

Do you need help with a Domestic/Dating Violence Restraining Order?

If yes, please mark the restraining order you need help with:

Physical

Financial

Stalking

Sexual Assault

Other

Do you need help with child custody?

Name of the opposing party:*

Address of the opposing party, if known:

Which one matches your household and monthly income:*

I claim one person on my taxes and do not make more than $2,430

I claim two persons on my taxes and do not make more than $3,287

I claim three persons on my taxes and do not make more than $4,143

I claim four persons on my taxes and do not make more than $5,000

I claim five persons on my taxes and do not make more than $5,857

I claim six persons on my taxes and do not make more than $6,713

I claim seven persons on my taxes and do not make more than $7,570

I claim eight persons on my taxes and do not make more than $8,427

None of the above

Do you have children with the opposing party?

Yes

Does the opposing party have an attorney?

Yes

I don't know

Briefly explain the problem:*

If you are eligible for free legal assistance, we will need to collect more information for our intake process. May we email you an intake form?

Yes

No, please call me

Please upload any important documents (optional) such as summons and complaint, and notices

I am requesting legal services for myself or for someone who has authorized me to provide their information. I understand that completing this form does not guarantee that services will be provided and does not create an attorney-client relationship.

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SLOLAF is a 501(c)(3) non-profit organization, so your gift is tax deductible.

Our Federal Tax ID# is 77-0335048

Main office:

3232 S. Higuera St., Suite 101D
San Luis Obispo, CA 93401

Phone: (805) 543-5140

info@slolaf.org

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