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:

Check this box once you've signed up for an appointment

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

Other Information

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.

Specific_Attorney

First Name:
Last Name:

Email Address:
Phone Number:

Is the fee being split with another agent?

(Agent splits are 50/50)

NO YES