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There are certain matters that we are unable to assist you with. For example, we would not be able to act in cases where:

There is a conflict of interest
You are not able to provide instructions
The legal problem involves an area of law that we do not practise
The legal problem is situated in a jurisdiction where we do not practise

If you require legal services which we do not provide, we may be able to refer you to another firm or organization that can assist you.

Client Information

Please ensure your name matches exactly as it appears on your government-issued identification. You will be required to provide a copy of your driver's licence or other proof of identification.

Full Legal Name

First Name *

Middle Name

Last Name *

Aliases / Other Known Names

Date of Birth *

Home Address

Address Line 1 *

Address Line 2

City *

Province

Postal Code

Country

Work Address

Address Line 1 *

Address Line 2

City

Province

Postal Code

Country

Contact Information

Phone Numbers

Home *

Office *

Cell *

Email Addresses

Primary Email *

Confirm Primary Email *

Alternate Email

I consent to receiving communications from DV Law by email. *

Background & Status in Canada

Current Status in Canada *

Country of Birth (if not Canada)

Do you have family abroad who may assist with your case?

Yes No

Is English your first language?

Yes No

First Language

Do you require an interpreter?

Yes No

Will you bring your own interpreter to meetings?

Yes No

Employment & Income

Are you currently working?

Yes No

Current Annual Income

Job Title / Description

How do you currently support yourself?

When did you last work?

Children

Do you have any children?

Yes No

Children Details

Full Legal Name	Date of Birth	Lives With	Grade & School	Biological Father

Are there any special considerations for the children? (medical, developmental, etc.)

Property & Assets

Property owned jointly with the opposing party or anyone else

Examples: house, business, bank accounts. Please list and include estimated values.

Property held solely in your name

Examples: personal bank accounts, vehicles, investments. Please list and include estimated values.

Reason for Your Visit

What is the primary reason for your visit today? *

Please summarize in point form.

Referral

How did you hear about DV Law?

Name of referring individual or agency

Opposing Party — Contact Information

Full Legal Name

First Name

Middle Name

Last Name

Aliases / Other Known Names

Date of Birth

Home Address

Address Line 1

Address Line 2

City

Province

Postal Code

Country

Work Address (if applicable)

Address Line 1

Address Line 2

City

Province

Postal Code

Country

Alternate Address (if applicable)

Address Line 1

Address Line 2

City

Province

Postal Code

Country

Contact Numbers & Email

Home

Office

Cell

Primary Email

Alternate Email

Thank you for taking the time to complete this form. Your answers will help us review and understand your case more quickly, making our meeting more efficient and productive.

Client Intake Form

Client Information

Contact Information

Background & Status in Canada

Employment & Income

Relationship & Marital Status

Children

Safety & Family Concerns

Property & Assets

Prior Legal Proceedings

Reason for Your Visit

Opposing Party — Contact Information

Opposing Party — Background & Employment