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Free Bankruptcy Evaluation and Fee Quote

DISCLAIMER: COMPLETING THE FORM DOES NOT CREATE AN ATTORNEY CLIENT RELATIONSHIP. Following your evaluation, to hire the Attorney, you and the Attorney must sign a Retainer Agreement. The Agreement will set forth the terms of representation. If the Attorney does not agree to represent you, or if no Agreement is signed, Attorney strongly urges you to immediately consult with other legal counsel to protect your rights. The Attorney’s decision not to represent you should not be taken an expression regarding the merits of your case.

Bankruptcy Evaluation Form

When completing the Form, if you are MARRIED, whether or not you are filing jointly or individually, to the best of your knowledge, please include all of your spouse’s information including  assets, property, financial accounts and income.

Please answer all questions. Feel free to type “na” if the question is not applicable. If you are having trouble with the form please feel free to complete this PDF Questionnaire and email to