Contact
Law Offices of Grant J. Gisondo, P.A. Logo

(561) 530-4568

Call For Free Consultation

9:00-5:00 M-F

Saturday Appointments Available

Palm Beach Gardens (Main Location)
500 Village square crossing #103
Palm Beach Gardens, FL 33410
Phone: 561-530-4568
Email: PBG@gisondolaw.com

West Palm Beach
777 South Flagler Drive, Suite 800 - West Tower, West Palm Beach, Florida 33401
Phone: 561-530-4486
Email: WPB@gisondolaw.com

Delray Beach
1615 South Congress Avenue, Suite 103,
Delray Beach, Florida 33445
Phone: 561-530-4669
Email: Delray@gisondolaw.com

Stuart
1 SE Ocean Blvd., Stuart, FL 34994
Phone: 772-742-4709
Email: Stuart@gisondolaw.com

9:00-5:00 M-F

Saturday Appointments Available

(561) 530-4568

Call For Free Consultation

Search
Menu
500 Village square crossing, #103 Palm Beach Gardens, FL 33410

FAMILY LAW CLIENT INTAKE FORM

INSTRUCTIONS: Please complete this confidential questionnaire, If you spend the time to complete all items, you will give us the background information necessary to begin to understand the complexity of the personal aspects of your family law problem. All information will be held in strict confidence.
* All fields must be filled out to submit the form. If something does not apply to you, please put N/A in the field
1. Please provide your full name, date of birth, place of birth, Social Security Number and Driver's License Number
2. Where are you living now?
3. Please complete following concerning your employment:
4. Please provide your spouse (or former spouse)'s full name, date of birth, place of birth, Social Security Number and Driver's License Number
5. Where are your spouse (or former spouse) living?
6. Please complete following concerning your spouse (or former spouse) employment:
7. Please provide the date and place of your marriage (if this is for a divorce proceeding):
10. If there are any children of this marriage, please provide all requested information:
#NameSexDOBPlace of BirthCurrent Residence
11. If known, please list all addresses the child(ren) has lived at for the last five years, or from the date of the Last Order in this case if less than five years ago.
14. What is your ideal timesharing agreement between yourself and the other parent?
15. Are there any reason why you feel as though Shared Parental Responsibility would not be in the best interest of the child(ren)? Areas of responsibility may include decision-making as to education, health care, and other major decisions for the child(ren).

Please circle type of Parental Responsibility you are seeking

17. Name of your spouse (or former spouse)'s attorney, if any:

18. Do you or your spouse (or former spouse) pay or receive child support

Describe child support payment $ per paid by

19. Are there any child support appears, if so, what is the approximate amount: $

Grant J. Gisondo, P.A.