Thank you for thinking of me and my firm when someone in your network needs legal help. I value the trust that referral partners place in us, and I want to make the referral process as straightforward and responsive as possible.

Please use this form to share the information you have about the prospective client and the legal issue. You do not need to have every detail before submitting it—basic contact information, the general nature of the issue, and any known deadlines will allow my team and me to begin an initial review. If the matter involves an upcoming hearing, arrest, detention, service of legal papers, protective order, or another immediate concern, please identify that in the form so we can prioritize the follow-up.

After receiving the submission, I will have the information reviewed for conflicts and intake purposes. We will contact the prospective client directly using the callback preferences provided below, unless you request that we contact you first. Please understand that a referral submission does not create an attorney-client relationship, does not confirm that I or my firm will represent the prospective client, and does not constitute conflict clearance.

I appreciate the opportunity to consider the referral and will make every effort to provide a timely response. Thank you again for your confidence in my practice.

Referral Partner Information

Contact information: Referring Contact

Prefix

First name *

Middle name

Last name *

Company

Emails

Email Address *

Type

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

Add email

Addresses

Street address

Country

City

State/Region

Zip/Postal code

Address type

Add address

Phone numbers

Phone number

Type

Add phone number

Prospective Client Information

Contact information: Prospective Client

Prefix

First name *

Middle name

Last name *

Date of birth

Emails

Email Address *

Type

Add email

Addresses

Street address

Country

City

State/Region

Zip/Postal code

Address type

Add address

Phone numbers

Phone number

Type

Add phone number

Referral Partner Information

Contact information: Referring Contact

Preferred method of contact

Relationship to prospective client

How did you learn of the potential matter?

Prospective Client Information

Contact information: Prospective Client

Preferred method of contact

Is an interpreter or other accommodation needed?

Matter Information

Type of legal matter

Date of Incident

Tell us about the case.

Where is the case?

Is there a hearing, court date, deadline, or other urgent date?

Court, agency, or jurisdiction involved

Case Number (if available)

Has the prospective client spoken with another lawyer about this matter?

Names of known opposing parties, adverse witnesses, or involved organizations

Has anyone been served with court papers, arrested, detained, or placed under a protective order?

Referral Notes and Documents

Additional notes for the intake team

May we update you on whether the firm can accept the matter?

I confirm that I have permission to share the contact information provided in this form with the firm for the limited purpose of evaluating this potential legal matter.

I understand that submitting this referral does not create an attorney-client relationship between the firm and the prospective client, does not guarantee that the firm will accept the matter, and does not establish a conflict clearance.