Get Hait & Kuhn Family Violence/ Stalking Intake

Filling out the Hait & Kuhn Family Violence/ Stalking Intake form is an important step in seeking the necessary support and protection. This guide provides clear, step-by-step instructions on how to complete the form accurately and efficiently.

Follow the steps to accurately complete the intake form online.

1. Press the ‘Get Form’ button to retrieve the intake form and open it for editing.
2. Begin by entering your name in the designated field at the top of the form.
3. Fill in the date of completion to ensure accurate record-keeping.
4. State your current employment status by marking 'Y' for yes or 'N' for no.
5. If employed, provide your average yearly income in the specified field.
6. Enter a phone number where confidential messages can be left.
7. Provide your email address to facilitate further communication.
8. Fill in your Social Security number in the format requested.
9. List an emergency contact person's name and phone number for urgent situations.
10. Describe how you were referred to the office to help track your case's origin.
11. Enter the name of the aggressor or stalker along with their county of residence.
12. Complete the aggressor/stalker’s address and email address if available.
13. Include the aggressor/stalker's social security number in the designated section.
14. Fill in their work address to provide more context regarding their identity.
15. Clarify your relationship to the aggressor/stalker in the specified field.
16. Provide a detailed description of the events that led you to seek a protective order.
17. List the proof you have to substantiate your claims, such as photographs or messages.
18. If applicable, list the names of children involved and their date of birth, noting their living arrangements.
19. Describe any involvement of the children in the alleged violence or stalking incidents.
20. Indicate whether you have ever filed for bankruptcy by marking 'Y' or 'N'.
21. State if you are considering filing for bankruptcy by marking 'Y' or 'N'.
22. Review the confidentiality note on the form to understand your rights related to the information provided.
23. Add any additional notes in the section provided for further clarification if needed.
24. Enter the retainer amount quoted, expected monthly payment, and estimated total for collaboration.
25. Once all fields are complete and verified for accuracy, you can save your changes, download a copy, print the form, or share it as required.

Start filling out your form online now to get the support you need.