RAVENNA OFFICE

330-296-8000

STOW OFFICE

330-686-2890

CLIENT INTAKE FORM: Domestic relations

    MaleFemale
    Address*:
    City*:
    YesNo
    E-Mail Address*:
    City of Birth:
    Date of Birth*:

    YesNo

    YesNo


    Opposing Party’s Address (if different):

    SelfOpposing PartyBoth
    YesNo

    Do you have any Children?YesNo

    Are you a currently employed?YesNo

    Please send us all files relevant to this case.
    You may send multiple files.
    Accepted file formats are zip, rar, pdf, doc, xls, ppt, jpg, jpeg, gif, png.


    Help Us Improve Our Services



    YesNo
    YesNo


    YOUR INFORMATION IS SECURE

    Information supplied in online forms is transmitted securely to Weisenburger Law Offices, LLC using Secure Sockets Layer (SSL). Ensuring that communications remain secure between users and the Web server is a critical issue. SSL is the protocol developed to transmit private information via the Internet. It works by using a public key to encrypt data that is transferred over the SSL connection. The key used for the encryption is contained in the site’s security certificate. This protects your login credentials, addresses, and other secure data. Please see

    Let's Encrypt

    Information provided to us is protected by the attorney-client privilege, which extends to all of our office staff.
    Any legal advice given is dependent upon the accuracy of the information you provide in this form.
    Please make sure that the information you provide is complete and accurate.