Initial Consultation Schedule Request

Your Information

First Name: *

Last Name: *

Contact Phone :*

Contact Email: *

Case Type *

Choose Date: *

Choose Time *

Party 1 Information

Party' Name:

Phone :

Email:

Party 2 Information

Party' Name:

Phone :

Email:

Please let us know of any special circumstances in scheduling this appointment

About Initial Consultations

Initial meetings are held via Zoom Video conference. Upon registration we will email you login information and instructions. Please notify us at least one business day (not counting weekends and holidays) if you need to reschedule or cancel a meeting.

Payment Information

Amount Due: $150.00

Card Number *

Exp Date (mmyy) *

Our office manager will call to confirm your request

Thank you!

Initial Consultation Schedule Request

Payment Information

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