Family Law Questionnaire: Contact a Mississauga Family Lawyer

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We speak
English and Hebrew.

CONSULTATION QUESTIONNAIRE

* Required Fields
Your Name
Salutation
First Name *
Last Name *

Contacts Please fill out information below with the understanding that whatever contact information you provide, we may use to contact you. You can provide all of them if you wish to get back to you by any of the methods described.
Home Telephone *
Mobile Telephone
Email*
Business Telephone
City/Town where you reside *
Province*

Work Information
Type of work you do
City/Town where you work

Spousal Information Please fill out the information so that we can check if your spouse has already contacted us.
Salutation
First Name *
Last Name *
Maiden Name (In case your spouse used her maiden name when she contacted us)
City/Town where your spouse resides *
Type of Work your spouse does
City/Town where your spouse works

Current Relationship with your spouse
Married*
Common Law *

Children Please enter n/a or none if not applicable.
Number of Children *
Ages of Children *
Who are they residing with *

General Comments



DeRusha Law Firm Contacting You One of our staff members will contact you within one business day. We will discuss the consultation process and choose a lawyer to meet with you if you wish the consultation to proceed. If we do not respond to you within one business day, you may wish to contact us directly by phone or email. Engaging DeRusha Law Firm You have not engaged our firm, and we are not acting for you, unless or until there is further contacts and a contract of hiring our firm is in place. We do not represent you just because you have provided us with some background information. We only represent you if and when we proceed with a consultation and you engage our firm to perform specific tasks on your behalf. We thank you for your patience and waiting for our contact to you before contacting other lawyers.