Wallacker Family Law | Mediation & Consulting
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Premarital, Post-marital, Cohabitation Agreements

Mediation

Confidential Initial Consultation Intake Form: Please complete all fields below that apply to you and your matter. This information will be used to run a conflict of interest check through our system and will be kept confidential. Not all fields will apply to your matter. If there is no conflict of interest and Gretchen is available to meet with you, Jeffrey will email you and the other party involved in the matter to schedule your initial consultation.

Step 1 of 3

Premarital, Post-marital, or Cohabitation Agreement

Please indicate whether you are reaching out for a Premarital, Post-marital, or Cohabitation Agreement:(Required)
Please select your preferred consultation type:(Required)

PARTY #1

Full legal name(Required)
Current home address(Required)
Maiden name or any name(s) used from former relationships
The name(s) of your former spouse(s)
First
Middle
Last
 
If you have children from another relationship, their names and ages
First
Last
Age
 
If employed, the name of your company and job title
If you have one, the name of your attorney (if you do not have an attorney, we can provide referrals)
If you have an attorney, would you like them to attend your mediation sessions?