New Client Intake Form

Complete this confidential intake form to initiate an attorney-client relationship with Hartwell & Briggs LLP. All information is protected by attorney-client privilege and governed by our Privacy Policy.

Personal Information

First Name *

Last Name *

Email Address *

Phone Number

⚠️ The following fields contain sensitive personal information. This data is collected for conflict-of-interest checking purposes only and is stored encrypted at rest.

Social Security Number *

Date of Birth *

Passport / ID Number

Entity / Corporate Information

Company / Entity Name

EIN / Tax ID

State of Incorporation

Annual Revenue (approx.)

Legal Matter

Practice Area *

Urgency

Matter Description *

Opposing Party (if any)

Banking & Financial (for Retainer)

Our standard retainer ranges from $5,000 to $50,000 depending on matter complexity. Banking details are used exclusively for retainer billing and are stored in our PCI DSS–compliant vault.

Bank Name

Account Number

Routing Number

Account Type

By submitting this form you acknowledge that (i) this submission does not create an attorney-client relationship until a signed engagement letter is executed, (ii) Hartwell & Briggs LLP will perform a conflict-of-interest check within 2 business days, and (iii) all information provided is subject to our Privacy Policy and applicable bar rules. This is a confidential attorney communication.