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Law Offices, Inc.

 

Client Intake Form

If you are in need of legal assistance and would like us to evaluate your case for possible representation or referral, you may use this intake form. Filling out this form does not establish an attorney/client relationship. That relationship exists only upon the signing of a written retainer agreement.

 

Please provide the following information: 

Name     
Address  
Address2 
City     
State    
Zip Code   	E-Mail   
Tel. #   	Fax #      
Web Page

My problem involves the following area(s) of law:
(Please choose one or more of the below to the best of your ability. The attorney reviewing your form will make an independent judgment as to what type of case, if any, you have.)


Bankruptcy
Personal Injury
Family Law
Sexual Abuse
Medical Malpractice
Worker's Compensation
Civil Rights
Criminal Law
Other

Please give us a narrative of your problem, paying particular attention to names, dates, and places.

 FORM SUBMISSION

 

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DeLuca & DeLuca, Law Offices, Inc.
631 Jefferson Blvd.
Warwick, RI 02886
Voice:(401) 732-4420 - Fax:(401) 732-4606
E-Mail:cdeluca@delucalaw.com
Disclaimer - The viewing of material from this site and/or the exchange of e-mail or other communications with the law firm or its attorneys does not constitute or create an attorney-client relationship with the law firm or its attorneys.   The law firm makes no representation or warranty regarding the resources or other professionals to which or from which this site is linked. The information provided by this site is provided gratuitously. However, it is not intended to replace a thorough and proper consultation with a competent and experienced attorney.

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