Family Law Intake Form

Information Center -Learn More- Family Law

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Office Location
109 Capitol Street
Suite 600
Renaissance Tower
Charleston, WV
25301
(304) 345-4455-TEL
(304) 343-6881-FAX
E-mail The Firm

*Name:

*Address:

*City:

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*Zip:

*E-mail address:

*Home Phone:

Business Phone:

Cellular or Pager:

Facsimile:

What type of family law matter are you interested in?

Are you currently married or cohabiting?
Yes No

Check one:
Married Cohabiting

If yes, list his or her name, date of birth, and date of marriage/cohabitation:

Do you have children?
Yes No

If yes, list their names and dates of birth:

Name	Date of Birth

If you have children, with whom and where do they live now?

Were you previously married?
Yes No

If yes, when and how did your previous marriage(s) end?

Is your case contested or do you anticipate you will meet opposition to your anticipated actions?
Yes No

Have you been served with papers in a family law matter?
Yes No

If yes, what is the name of the opposing party and his or her attorney (if known)?

What is your relationship with the opposing party?

If "Other Relationship," please explain:

Have you appeared in court or agreed on terms related to this matter?
Yes No

Do you have copies of any documents (court decrees, dissolution agreements, etc.) related to this matter?
Yes No

What types of documents do you have?

Is domestic violence an issue in this matter?
Yes No

If yes, please describe, including any court actions and incident dates.

Is property at issue?
Yes No

If yes, please describe the property and anything known with regard to legal ownership.

Are you or any person involved in this matter currently pregnant?
Yes No

Where did you hear about this website?

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The law firm of Julia Shalhoup in Charleston, West Virginia represents clients throughout the state, including the communities of Hurricane, Winfield, Madison, Montgomery, Elkview, Ripley, Beckley, Hamlin, and Spencer, and Putnam, Kanawha, Boone, Lincoln, Jackson, Roane, Cabell, Clay, Nicholas, and Raleigh counties.