Weinstein Law
Weinstein Law
130 Cone Street, Suite A
Atlanta, GA 30303
470-889-7337
Thank you so much for contacting Weinstein Law! Please read the privacy policy below, and then fill out this form in whole or in part prior to our consultation.
The initial contact information is for you. If you are contacting us for help with someone else (like a friend or loved one who may be unable to reach out), we will provide a place to provide his information.
Privacy Policy
All information received from a client is strictly confidential. Our firm takes every step possible to protect your privacy. The data submitted via this form is encrypted and secured using industry-standard 256-bit SSL encryption.
Contact information: Your Contact Information
Prefix
First name
*
Middle name
Last name
*
Emails
Address
*
Type
Upon submission, a copy of this form will be sent to the primary email.
Work
Home
Other
Primary
Default email false
Add email
Phone numbers
Phone number
Type
Work
Home
Mobile
Fax
Pager
Skype
Other
Primary
Add phone number
Preferred Contact Method
Select an option
Email
Phone
No Preference
Gender of Charged Person
Male
Female
Contact information: If calling for someone else, please provide their info here
Prefix
First name
*
Middle name
Last name
*
Date of birth
Emails
Address
*
Type
Work
Home
Other
Primary
Default email false
Add email
Phone numbers
Phone number
Type
Work
Home
Mobile
Fax
Pager
Skype
Other
Primary
Add phone number
Marital Status of Charged Person
Single
Married
Spouse's Full Name
Separated
Spouse's Full Name
Divorced
Former Spouse's Full Name
Widowed
Former Spouse's Full Name
How were you referred to Doug Weinstein?
Friend or family member
Input the person's full name:
Another attorney
Input the attorney's full name:
Online search or lawyer directory website
Input the name of the website:
For example, "Avvo", "Facebook", or "LawFirmName.com"
Bar Association
Which Bar Association?
Other
Please explain how you found us:
Legal Problems Faced
Please complete this to tell Doug Weinstein some basic information about the situation. It will make our meeting more productive.
What charges are being faced?
Charges?
What County or City are the Charges In?
Is the Charged person currently in custody?
Yes
Where?
No
If our law firm ends up representing you in this matter, will you be the person who pays the legal fees?
Yes
How do you plan to pay?
Please indicate the source of funds or otherwise confirm that you have the ability to pay your legal fees.
No
Input the full name of the person who will pay the legal fees:
Input his/her phone number:
Input his/her email address:
Please acknowledge that you have read and hereby accept the above privacy policy regarding use of my personal information by typing your full legal name below
THANK YOU
Thank you so much for completing this intake questionnaire. This information will be extremely helpful in evaluating your case. We will contact you as soon as possible with any updates.
Please click the
SUBMIT
button below when you have finished answering all questions.