ME Law Conflict Check Form

Please state whether you are: *

Prospective Client`s full name: *

Marital status *

Spouse name: *

Will you require: *

Please list all Client names *

Email *

Address

Street Address *

City *

Province *

Country *

Postal Code *

Phone *

Opposing Party`s name *

Have you ever worked with a lawyer on your current issue before? *

Do you currently have a retainer agreement/ lawyer in record? *

What is the reason why you want to change your existing counsel? *

Provide the lawyer`s / firm name

Please check the issue you need advice on or assistance with *

Please outline (e.g. contract breach, application, injunction, etc) *

Please check the issue you need advice on or assistance *

Tell us more about your matter: *

Has a proceeding begun? *

Please indicate your position *

Please check what items you can provide to us for the purpose of review *

How did you hear about us? *

I confirm that the information provided above is complete and accurate to the best of my knowledge. I understand that the Firm will rely on this information to conduct a conflict of interest review. I agree to promptly notify the Firm if I become aware of any changes or additional information that may affect the conflict assessment

The information provided in this form will be used solely for the purpose of conducting a conflict of interest review. Submission of this form does not establish a solicitor-client relationship. Representation is subject to the Firm’s approval following completion of its conflict review process.