LITC Potential Client Intake Form

  • Please note that you do not automatically become a client by submitting this form. After receiving your completed form, the LITC will contact you to set up an initial consultation meeting to determine if we can accept you as a client. Please leave blank if it does not apply to you or you do not know. Please note that information sent by potential or current clients is confidential to the client, and as such will not be shared with any third parties outside of WashULaw LITC or others unless they have signed an explicit confidentiality agreement. About You
  • Types of Income Please tell us how much income you receive from the following sources. Please specify how often you receive this income (weekly, biweekly, monthly, etc.) Leave blank if it does not apply to you:
  • Must be a dollar amount.