Real Estate Law Intake Form

 

Case Name
Date Lawsuit Filed
Venue
Case Number (if applicable)
IF CASE HAS NOT BEEN FILED, LIST DATE OF BREACH OF CONTRACT OR OTHER ISSUES TO BE MEDIATED
Your name (Required)
Telephone Number (Required)
PREFERRED DATES FOR MEDIATION: (Please List Two dates if you can)
First Choice
Second Choice
What was the major issues that brought this case to mediation
Preferred Location of Mediation
OTHER REAL ESTATE OFFICE OR ATTORNEY
Name
Firm
Telephone number
ANY PRIOR MEDIATIONS?
Yes
No
If Yes, Mediators Name
If Yes,Dates of prior mediations
Verification (to make sure you're human)

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Note: Please do not include any URLs in form.