Client Intake Form George Henry Partners LP Client Intake & Engagement Request Primary Contact Contact Person Name The individual who will be our main point of communication. Client Details Client Type Individual Company Company Name First Name Last Name Email Address Phone Number Date of Birth / Formation Nationality British Virgin Islands USA United Kingdom Other... Additional Nationalities Physical Address Street Address City State / Province Postal / Zip Code Country British Virgin Islands USA United Kingdom Canada Engagement Details Description of Legal Assistance Required Is this a joint matter? (Select option) No - single client Yes - joint clients Relationship (if joint) (Select relationship) Spouse/Partner Sibling Parent/Child Business Partner Other Secondary Client First Name Secondary Client Last Name Secondary Email Secondary Phone Conflicts & Related Parties Check To ensure we can represent you, please identify all other parties involved. Related Party First Name Related Party Last Name Other Related Parties Adverse Party First Name Adverse Party Last Name Other Professionals (Accountants, Agents, etc.) Billing Information Billing First Name Billing Last Name Billing Email Address
