Case Evaluation Form Robert Koop Johnson P.A. Attorneys Naples Florida

*Name:

*Address:

*City:

*State:

*Zip:

*E-mail address:

*Home Phone:

Business Phone:

Cellular or Pager:

Facsimile:

What type of family law matter are you interested?

Are you currently married or cohabiting?
YesNo

Check one:
MarriedCohabiting

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

Do you have children?
YesNo

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? YesNo
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? YesNo
Have you been served with papers in a family law matter? YesNo
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? YesNo
Do you have copies of any documents (court decrees, dissolution agreements, etc.) related to this matter? YesNo
What types of documents do you have?
Is domestic violence an issue in this matter? YesNo
If yes, please describe, including any court actions and incident dates:
Is property at issue? YesNo
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? YesNo
Where did you hear about this website?

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