Reason for Consultation (i.e. divorce, separation, marriage contract, general consultation, second opinion):
Referral Source:
Full Legal Name:
Date of Birth:
Place of Birth:
Citizenship:
SIN Number:
Surname at Birth:
Surname Before Marriage:
Current Home Address:
Since When?:
Current Mailing Address (if different from home address):
Home Tel.:
Work Tel.:
Cell:
Fax:
Email:
Preferred Method of Communication:
Divorced Before?:
Place and Date:
Job Title:
Current Employer and Address:
Current Annual Income From Employment:
Income From Other Sources:
Current or Previous Family Lawyer:
Spouse’s Lawyer and Contact Information:
Date of Marriage:
Date of Cohabitation:
Place of Marriage:
Date of Separation:
Have either you, your spouse, or children been in a court case before?
Have you and your spouse made a written agreement dealing with any matter involved in this case?
If client or spouse is stay-at-home parent, please give relevant dates:
Do you have any safety concerns for yourself or your children?
Have the police been called to the matrimonial home and does either spouse have a criminal record?
First:
Address:
Name(s) on Title:
Value:
Mortgage:
Second:
Received by client (during or after marriage):
Received by client’s spouse (during or after marriage):
Please list all children including their name(s), date of birth, who they're living with and current grade/school:
Medical/Dental/Orthodontic:
Private School/Tutoring/Educational Expenses:
Post-secondary Educational Expenses:
Daycare/Child Care:
Extracurricular Activities:
Other Expenses: