PCNR Intake Form

CHUNG, MALHAS & MANTEL PLLC

PLEASE READ CAREFULLY & SIGN BELOW

Following your initial interview, if you agree to hire CHUNG, MALHAS & MANTEL, PLLC, and CHUNG, MALHAS & MANTEL, PLLC agrees to represent you, you will both sign an Agreement for Legal Representation. The Agreement for Legal Representation will set forth the terms and conditions of representation.

If CHUNG, MALHAS & MANTEL, PLLC is willing to represent you and you decide not to sign an Agreement for Legal Representation on the day of your consultation, you are strongly urged to schedule a second appointment for signatures with the Attorney at the earliest possible time or to immediately consult with other legal counsel to protect your rights.

NOTICE : This office does not represent you with regard to the matters set forth by you herein in this information sheet or discussed during your consultation unless and until, both you and the Attorney execute a written Agreement for Legal Representation.

If CHUNG, MALHAS & MANTEL, PLLC does not agree to represent you, this includes not representing you with regard to the matter set forth by you on this information sheet, nor any other matters you may discuss with the Attorney during your consultation. If your legal problem(s) involve a potential lawsuit, it is important that you realize a lawsuit must be filed within a certain period of time called a Statute of Limitations. Therefore, the
Attorney strongly urges you to immediately consult with another attorney to protect your rights. The Attorney’s decision not to represent you should not be taken by you as an expression regarding the merits of your case.

Your signature acknowledges only that you received a copy of this completed information sheet and does not mean you have hired the Attorney.