In which county do you reside?
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| Have you lived in Massachusetts more than one year? |
Yes No |
| If you have children, please tell us how many and their ages: |
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| Do you own or rent your present home? |
Own Rent |
| If you own your home, what is the approximate market value? |
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| If you own your home, what is the approximate mortgage balance? |
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| What is your occupation? |
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| What is your wage or salary? |
Less than $10,000
$10,000-$50,000
$50,000-$99,999
$100,000-$149,999
More than $150,000
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What is your spouse’s occupation?
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What is your spouse’s wage or salary?
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Less than $10,000
$10,000-$50,000
$50,000-$99,999
$100,000-$149,999
More than $150,000
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Do you and/or your spouse have a retirement plan?
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Yes No |
Do you have a family-owned business?
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Yes No |
Do you or your spouse own a professional practice?
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Yes No |
Are you concerned about hidden assets or un/under reported income?
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Yes No |
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What type of services are needed (check all that apply)?
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Contested Divorce
Uncontested Divorce
Same-Sex Divorce
Paternity
Restraining Orders
D.C.F.S. Defense
Custody and Parenting Plans
Child Support Issues
Alimony & Spousal Support
Income Attribution
Separation Agreements
Property Distribution
Business Valuation
Tax Issues
Divorce Estate Planning
QDROs
Prenuptial Agreements
Forensic Investigations
Father’s Rights
Grandparent Rights
Guardianship
Adoption
Parental Relocation
Interstate & Intl. Custody
Gay & Lesbian Custody
Post-Divorce Modification
Contempt Matters
Post-Divorce Collection
D.O.R. Representation
Mediation
Appellate Review
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Please describe your situation:
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What goals do you wish to achieve?
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Are you currently represented by another attorney relating to this matter?
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Yes No |
If yes, in which county was your case filed?
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Is there an upcoming hearing scheduled in this matter?
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Yes No
If yes, what is the date? |
Who is your Judge?
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I am not sure |
| Are you interested in scheduling an appointment to meet with Attorney Pollack, or a staff attorney in your area? |
Yes No |
| If yes, in which office |
Woburn
Norwood
Plymouth
Springfield
Worcester |
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Which of the following meeting times would be most convenient for you? (You may choose more than one).
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Early Morning Weekdays
During the Workday
Evening Hours
Weekends |
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When do you anticipate retaining a lawyer for this action?
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Immediately
Within two weeks
Within one month
Within three months |
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How will you pay for legal services when you hire your attorney?
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Funds are available
Credit card
Personal savings
Loans from friends/family
Other |
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How would you prefer that we contact you ?
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