Guardianship Client Intake Form - Plenary

Thank you for contacting The Law Office of Pamela G. Martini. The information you provide in this form will automatically populate to our case management software so please check all spelling carefully and provide as much information as you can. My staff and I look forward to exceeding your expectations at every step of the guardianship process and to building a lasting relationship that you can depend on!

Today's Date *

I would prefer *

Initial Consult in person
Initial Consult via telephone

Whom may we thank for referring you?

STEP ONE: Client/Proposed Guardian Information

First Name *

Middle Name

Last Name *

Email *

Best Phone Number to Reach You During the Day *

Street Address *

City *

State *

Zip Code *

Preferred Method of Communication

Date of Birth *

County of Residence *

STEP TWO : Proposed Ward's Information

Please enter the current contact information for the proposed Ward

First Name *

Middle Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Phone Number *

Full Name of Spouse of proposed Ward (if applicable and other than client)

Date of Birth *

County of Residence *

Names and Addresses of Other Next of Kin of Proposed Ward

Proposed Ward has the following estate plan documents in place (check all that apply)

Durable Power of Attorney
Designation of Health Care Surrogate
Living Will
Last Will & Testament
Revocable Trust
Other

Name of Agent Appointed under Durable Power of Attorney (if applicable)

Name of Health Care Surrogate (if applicable)

Relationship of Client to Proposed Ward

The Proposed Ward has the following property/income sources (check that apply):

Homestead
Other Real Property
Bank Account(s)
Investment Account(s)
Retirement Account(s)
Social Security Retirement Income
Other Income

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Please fill in all the required fields before submitting this form.