*all fields are required


Date of Birth










Treatment Date:







Choose One…St PetersburgRiverviewWeb Inquiry/Other
Would you like to attach any files?

Contract Sent?
YesNo

Filled Out By:
—Please choose an option—AmandaAustinDavidDilainyKarenLesaMariaRangerSeanTaylor

DOB for the person charged

Language
EnglishSpanish




Which line did they call?
Choose One…St PetersburgRiverviewWeb Inquiry/Other Lead


Description of Issue:

What type of work do you do? Or are you in school?
If they seem bothered by this question: you can explain that the attorney needs to know how flexible their schedule is in regards to court appearances. Also, sometimes charges are a concern if their job requires periodic background checks or more often in regards to driver’s license status.)

Transfer to an Attorney:
Send to AllSamaraRangerAlecSeanMarina
Would you like to attach any files?

Filled Out By:
—Please choose an option—DavidDilainyKarenLesaMariaMarina F

Which line did they call?
Choose One…St PetersburgRiverviewWeb Inquiry/Other Lead
Do they have current EP docs that they are updating, or is this the first time?

Do they have children? Are they adults or minors?

Do they own their home?

Do they have any rental properties?

Do they own a business?

Do they have any other substantial assets?

Would you like to attach any files?

Filled Out By:
—Please choose an option—DavidDilainyKarenLesaMaria

Which line did they call?
Choose One…St PetersburgRiverviewWeb Inquiry/Other Lead
Relationship to the decedent?


Decedent’s Date of Birth (DOB)

Date of Death (DOD) – When did their loved one pass away?

Did the decedent have a will?

Did they have any assets (homes, land, investments, bank accounts, cars, insurance etc) in Florida or elsewhere?
Try to get addresses involved.

Is the PNC the named personal representative (“PR”) of the decedent?

Are there additional heirs (surviving spouse, adult children, etc)

Do they have any rental properties?

Do they own a business?

Do they have any other substantial assets?

Would you like to attach any files?

Filled Out By:
—Please choose an option—DavidDilainyKarenLesaMaria

Which line did they call?
Choose One…St PetersburgRiverviewWeb Inquiry/Other Lead

Relationship to the Case

What is your relationship to the person who passed away?
Are you calling on behalf of yourself or someone else? (If someone else, who?)

Details of the Probate Matter

Name of the Decedent:

Date of Death:

County in Florida where the decedent resided at the time of death:

Is there a will or trust involved?
WillTrustBothNeitherUnsure
Do you have a copy of the document(s)?
YesNo

Is there an existing probate case filed in court?
YesNoUnsure

What is the primary issue or dispute?
Validity of the willTrust disputesDisputes over distributionExecutor misconductOther

Parties Involved

Who are the other parties involved in the dispute? (e.g., family members, beneficiaries, executors, trustees)






Are any of these parties represented by an attorney?
YesNoUnsure

Assets and Financial Information

Approximate value of the estate/trust:
Under $500,000$500,000–$1MOver $1MUnsure
Types of assets:
Real estateBank accountsInvestmentsPersonal propertyBusiness interestsOther

Are there any disputes over specific assets?
YesNo

Legal and Procedural History

Has any legal action been taken related to this matter? (e.g., lawsuit filed, mediation, hearings)
YesNoUnsure

Are there any upcoming court deadlines or hearings?
YesNoUnsure

Have you previously consulted with or hired another attorney for this matter?
YesNo

Caller’s Goals and Expectations

What outcome are you seeking? (e.g., contest the will, remove executor, recover assets)

Are you able to pay for legal services, or are you seeking representation on a contingency basis?
Can pay hourly/feesSeeking contingency (refer out)
Any other relevant information provided by the caller:

Additional caller information:
Eval Team observations (e.g., caller’s demeanor, urgency):

Would you like to attach any files?

Filled Out By:
—Please choose an option—DavidDilainyKarenLesaMaria

Which line did they call?
Choose One…St PetersburgRiverviewWeb Inquiry/Other Lead
Full Street Address of the property to be transferred by Deed (the “Property”)

Is the Property vacant land or is there a structure (building) on the Property?
Vacant LandStructure on Property
The names of the current owners of the Property.

How is the caller involved with the Property?

Is there a specific deadline to have the Deed completed?
YesNo

Is there a mortgage on the Property? (If they mention any liens on the property please make a note.)

The name, address, and relationship to current owner (spouse, child, etc.) for all other persons to be included on the deed.