Payment Received — Client Intake

Thank you for choosing Miles & Daniels Firm. Please complete and submit the Client Intake form below to provide our team with the information needed to review your purchased service.

Please complete this form before closing this page. If you leave this page before submitting your intake, please contact [email protected] for assistance.

Upon submission, our team will review the information provided and determine the appropriate next steps for your purchased service.

All services remain subject to the scope and terms applicable to the service purchased.

Section 1 — Contact Information

Full Name *

Email Address *

Please use the same email address provided during checkout. Initial communications regarding your request will be sent to this email address. Please ensure it is accurate and regularly monitored.

Phone Number *

Section 2 — About Your Request

Briefly describe the question, concern, or matter you would like Miles & Daniels to address. *

Please provide a brief summary only. Miles & Daniels will request additional information if necessary after reviewing your submission.

1500 characters remaining

Are there any important dates or deadlines related to your request? *

YesNo

Before You Submit

Please do not include or submit confidential documents, personnel records, medical information, Social Security numbers, financial account information, or other sensitive documentation through this form.

If documents or additional information are necessary and within the scope of your purchased service, Miles & Daniels will provide instructions after reviewing your request.

If you believe a document needs to be reviewed but your purchased service does not include document review, you may note this in your request. Miles & Daniels will determine whether document review is necessary and, if applicable, advise you of the appropriate service option.

Submission of this form does not expand or modify the scope of the service purchased. Requests for services or work outside the scope of the original purchase may require a separate service purchase or engagement.

I confirm that the information provided in this Client Intake is accurate to the best of my knowledge and relates to the service I purchased.