Law Offices of Kendra L. Rimbert

LEGAL CLIENT INTAKE

Secure Matter Intake Portal

Please complete each section carefully. Your information is saved securely as you progress. You may save your application and return later.

Matter Status

In Progress

Completion

Case Info

Personal

Employment

Accident

Vehicles

Injuries & Treatment

Health Insurance

Medicare

Priors & Other

Documents

Review

Signature

Step 1 of 120%

Case Info

Case Information

Date of Intake

Intake Person

Matter Number

Referral Source

Did you have a prior attorney?

yes

Companion Case(s)?

yes

Vehicle Information — please do not skip

Does property need to be resolved?

yes

Is the vehicle drivable?

yes

Was vehicle towed from scene?

yes

Are you the titled owner?

yes

Do you have a loan/lien on your vehicle?

yes

Location of Vehicle

Who is your lien holder?

How much is the lien?

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