CONTRACT REVIEW CLIENT INTAKE FORM

DISCLAIMER: Thank you for your interest in being a client of [NAME OF LAW FIRM OR LAWYER]. Information collected about new clients is confidential and will be treated accordingly.

CLIENT INFORMATION

Client Name: _____________________ Entity Type: _____________________
EIN / Federal Tax Identification Number: _______________________________
Street Address: _______________________________
City: _____________________ State: _____________________ ZIP Code: ________
Company Website: _____________________
Describe the nature of your business: _____________________________________
Contact Person Information
Contact Name: _____________________ Job Title: _____________________
Primary Phone: ___________________ Secondary Phone: ___________________
E-Mail: _____________________ Fax: _____________________

CONTRACT INFORMATION

Contract Type: ___________ Contract Term (if any): ___________
Anticipated Contract Value: $___________
Date Submitted for Review: ___________ Requested Deadline: ___________

List and provide copies of or links to any policies, regulations, or laws that were relied on in developing this contract: ______________________________

What portions of the contract are you unsure about? ______________________________

What sections/language would you like to add? ______________________________

List and attach the main contract documents (including attachments and exhibits) and specify the number of pages for each: ______________________________

Provide any other information that may assist us in the review of your contract: _______________________________________________________

SIGNATURE

Signature: _____________________________ Date: ____________________

Printed Name: ____________________