Intake Sheet, Regional Law Center
This intake form was created directly from an Excel spreadsheet. It is here, however, a pure 'html' form. P
lace this form on your website and direct a client or customer to it for completion. When the client/customer presses 'Submit,' the data can be sent directly back to you via email. Pathagoras can, in turn, convert the data into an Instant Database record.
DCSE Case Number
Date of Marriage
Place of Marriage
Date of Separation
Date of SepAgree.
Opp. Atty Name
Opp. Atty Address1
How can we be of service to you?
Example: Step-parent adoption
Please list any other information you feel would be helpful, and/or anything you would like to discuss:
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