New Client Intake Form New Client Intake Form About YouAbout Your SpouseAbout Your Children / Step-ChildrenAdditional ChildrenCurrent AssetsPrior assets/debtsAcquired AssetsConcerns About You First name * Last name * Aliases and all previous names Preferred email address (home) * Home address Home address Home address Home address City City State/Province State/Province Zip/Postal Zip/Postal Phone (work) Leave message at work? OK to leave a message Don't leave a message Phone (cell/home) Leave message at cell/home? OK to leave a message Don't leave a message Do not contact me by: Email Do not contact me by phone Phone Do not contact me by mail Mail How did you hear about us? Place of birth Date you started living in BC Date you started living with your spouse Date of marriage (if applicable) Place of marriage (if applicable) Do you have original government issued certificate of marriage? Yes No Marital status before marriage? Never married Divorced Widowed Date of separation Name of employer Occupation Annual income from all sources $ .00 Do you have a disability or a medical condition? Yes No Please provide details * Any written agreement or court order between you and your spouse? Any written agreement or court order between you and any previous spouses or concerning any other children you have? About Your Spouse If you are human, leave this field blank.
