Intake Form

All potential clients in civil matters must complete our intake form before meeting with an attorney. This information is required by our ethical requirements as attorneys and to help us report how many people we help to funders.

During our walk-in hours, lawyers meet with clients in the order we receive intake forms (with some exceptions). We do not accept forms before the walk-in clinic begins, but you can complete the form before you arrive.

Download and print our intake form

If you complete the form at home, you must print and bring the form with you. We do not receive the form electronically.

YOU MUST MEET OUR INCOME GUIDELINES TO QUALIFY FOR SERVICES. For most case types, client’s income must be less than 125% of the Federal Poverty Level.

125 % of Poverty Guidelines 2018 

Household Size
Annual Income
Monthly Income
Weekly Income
Hourly Income
1 $15,175 $1,265 $292 $7.30
2 $20,575 $1,715 $396 $9.90
3 $25,975 $2,165 $500 $12.50
4 $31,375 $2,615 $603 $15.10
5 $36,775 $3,065 $707 $17.70
6 $42,175 $3,515 $811 $20.30
7 $47,575 $3,965 $915 $22.90
8 $52,975 $4,415 $1,019 $25.50