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CLIENT APPOINTMENT REQUEST

This form is used to schedule your client for an appointment
with a specific attorney or LSPN Staff Member.

ALL FIELDS ARE REQUIRED

Client

First Name:

Last Name:

Email Address:

Phone Number:

City:

State:

Scheduling Information

Important Notes to consider before requesting a time block:

Initial Consultations are scheduled for 30 minutes.
Time Blocks listed are in two-hour blocks of time.
The 30-minute initial consultation will be scheduled within the Time Block requested.

You must allow at least 3 days for the appointment to be made.

Consultation Day:

CLIENT'S Time Zone:

Consultation Time BLOCK:

Additional Information

Please give as much detailed information about the client's Estate Plan needs as possible

Attorney

If you are looking to work with a specific attorney, please list name below.

You must allow at least 3 days for the appointment to be made.

Field Agent

First Name:

Last Name:

Email Address:

Phone Number:

2nd Field Agent

Is the fee being split with another agent?
(Agent splits are 50/50)

NO YES