Get General Intake Form - Bailey & Galyen

Completing the General Intake Form is an essential step in initiating your legal consultation with Bailey & Galyen. This guide provides clear and supportive instructions to help you fill out the form accurately and efficiently, ensuring that your information is submitted correctly.

Follow the steps to complete the General Intake Form with ease.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your personal information in the designated fields. Fill in your full name, including your last name, first name, middle name, and maiden name, if applicable. Next, provide your date of birth and select your sex.
3. Add your place of birth, including the city, county, state, and country. Make sure to verify the accuracy of the details entered.
4. Input your Social Security number and driver's license number along with the issuing state.
5. Complete your address details, including street address, apartment number (if applicable), city, county, state, and ZIP code.
6. Provide your home phone number, work phone number, email address, and cell phone number. You may check the boxes to authorize emails concerning your case, general interest updates, and follow-up calls.
7. Fill in your place of employment, job title, and the address of your workplace. Make sure to include the city, state, ZIP code, and your annual salary.
8. If applicable, enter your spouse's name, maiden name, date of birth, and address (if different from yours).
9. Complete the section for the person financially responsible for the case by entering their name, date of birth, address, and phone number.
10. Provide emergency contact information including their name, address, home phone, and work phone.
11. Respond to any legal action inquiries regarding past involvements and accidents within the last two years, including inquiries about serious injuries from drugs, wills, Social Security benefits, Veterans benefits, and immigration matters.
12. Indicate your purpose for visiting today, and how you were referred to Bailey & Galyen.
13. Before finalizing, review all entered information for accuracy. Once confirmed, you can save your changes, download, print, or share the form as needed.

Complete your General Intake Form online with confidence and take the first step towards receiving legal assistance.