Estate Planning Intake Form

  • Confidential Estate Planning Questionnaire


    We realize this is an extensive questionnaire, but completing in advance of our meeting will allow us to maximize our time together. Experience has shown us that the more information that you provide upfront, the more we will be able to explore your unique concerns so we can craft the appropriate solutions.



  • 1st Party
  • Enter your full legal name
  • Date Format: MM slash DD slash YYYY
  • EmployerOccupation 
    If retired, please list your former occupation(s)
  • Only select if you are not a U.S. Citizen

  • 2nd Party (if applicable)
  • Enter your full legal name
  • Date Format: MM slash DD slash YYYY
  • EmployerOccupation 
    If retired, please list your former occupation(s)
  • Only select if you are not a U.S. Citizen

  • Previous Marriages

  • Date Format: MM slash DD slash YYYY
  • Please enter a number from 1 to 99.
  • Date Format: MM slash DD slash YYYY

  • Questions About You

  • If you are receiving disability benefits, please indicate 1) the nature of your disability; 2) how long you have been receiving disability benefits; 3) the source and amount of your disability benefits; and 4) whether your disability is a result of a military service injury.
  • ex. 1998, 1999, 2006
  • Have you completed estate planning documents such as
  • If yes, please bring either the original or copies of those documents with you to your consultation.
  • If yes, please bring either the original or a copy of the policy summary or contract with you to your consultation.
  • If yes please provide brief details


  • Children


    Check the Special Needs box if any child is unable to care for them selves. (Please list and indicate if any of your children are deceased. If a child is deceased, please indicate the date of their passing and whether they were survived by any children.)
  • NameAgeBirth DateSpecial Needs? 
  • During your consultation, your job will be to teach us about you and your family. We will ask a number of questions designed to help us better understand you and your family, the concerns and fears that you have, and the objectives you seek to accomplish. Although we realize that some questions may appear intrusive, please understand that we can only help you address the concerns and fears of which we are aware. For every concern of fear, there are many planning solutions.

    Some questions for you to consider in advance of your consultation and which we discuss are:
    • Your relationship with each of your children.
    • Each child's relationship with their siblings.
    • Does your child manage money well or does money manage your child?
    • Does your child have a history of stable employment? If not, why?
    • If you child is married, do you have any concerns about his or her marriage relationship?
    • How many times has a child been married?
    • If your child is married, how does his or her spouse get along with you and the rest of your children?
    • Is your child on who is an "influencer/leader" or one who is "easily influenced"?
    • Does your child suffer or struggle with any addictive behavior?
    • Whether there are relatives who would be poor, abusive, or even dangerous guardians?
    • Whether there are acquaintances and relatives who should no the allowed to be along with your children?

  • Other Dependents


    Family members (elderly parents/disabled siblings) or fiends who are dependent on you for their care.
  • Full Legal NameRelationshipSpecial Needs 


  • Questions About Your Children or Other Beneficiaries

  • This field is for validation purposes and should be left unchanged.