If your child is facing a juvenile court hearing, he or she needs experienced legal representation to ensure the best possible outcome. To get things started, your child’s attorney will need some basic information about you and your child. Be prepared to share the following information at your first meeting with your child’s lawyer. If you are married, both parents can complete the relevant portions of the same form. If you are not married, or if the other parent is not involved, complete just those portions that apply to you.
Intake Form: For Parents Seeking Legal Representation on Behalf of Their Child
INFORMATION ABOUT THE CHILD
Child’s Name ____________________________________________
Child’s Date of Birth ______________________________________
Child’s Social Security Number _____________________________
Child’s Address __________________________________________
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____________________________________ County
With whom does your child reside? __________________________
Does your child attend school? Yes _____ No _____
Name of school _______________________________
Does your child have a job? Yes _____ No _____
Name and address of child's employer ______________________________________________
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Is your child currently in the custody of juvenile authorities? Yes _____ No _____
Describe the circumstances that led you to seek legal representation on behalf of your child.
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List the names of any other persons who may have first-hand knowledge of these events, and the best way to contact them. ________________________________________________________
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Do you consider the charges that have been raised against your child to be true?
Yes _____ No _____
Why or why not? _______________________________________________________________
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Does your child consider the charges that have been raised against him or her to be true?
Yes _____ No _____
Why or why not? _______________________________________________________________
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Has your child previously been charged with an offense? Yes _____ No _____
If yes, explain: _________________________________________________________________
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What was the outcome? _________________________________________________________
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Does your child have a history of mental illness? Yes _____ No _____
If yes, explain: _________________________________________________________________
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Does your child have a history of alcohol or drug abuse? Yes _____ No _____
If yes, explain: _________________________________________________________________
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INFORMATION ABOUT THE PARENTS
MOTHER FATHER
Name ________________________________ ____________________________________
Date of Birth __________________________ ____________________________________
Address, Including County
_______________________________ ___________________________________
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Home Telephone Number ____________________ ____________________
Work Telephone Number ____________________ ____________________
Facsimile Number ____________________ ____________________
E-mail Address ____________________ ____________________
Best Way/Time to Reach ____________________ ____________________
Employer ____________________ ____________________
Position ____________________ ____________________
Employer’s Address
_______________________________ ____________________________________
_______________________________ ____________________________________
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Are you currently married to each other? Yes _____ No _____
Have you ever been married to each other? Yes _____ No _____
Other Children
Name Date of Birth Residing with Child of Mother,
Whom? Father, or Both?
_______________ _________ _______________ ______________
_______________ _________ _______________ ______________
_______________ _________ _______________ ______________
_______________ _________ _______________ ______________
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Other Important Information
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Questions to Ask My Attorney
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Contact a qualified family law attorney to make sure your rights are protected.