top of page
01. Personal Information

Ensure all personal details are accurate and current. This information is used for identity verification and to ensure we can reach you promptly concerning your case in Chesapeake, Virginia.

02. Confidentiality & Security

Your privacy is paramount. In accordance with Celtic integrity and legal standards, all data transmitted through this intake form is encrypted and treated with the highest level of professional confidence.

03. Case Preparation

The details you provide help our legal team prepare thoroughly for your consultation. Please be as descriptive as possible regarding the nature of your family law matter to ensure a productive first meeting.

Case Details Questionnaire

Please complete all required fields. Submitting this form does not create an attorney-client relationship.

Section 1 — Client Information

Date of birth
Month
Day
Year

Section 2 — Conflict Check

Have you ever been represented by Ireland Law?
Yes
No
Has anyone else involved in this matter ever been represented by Ireland Law?
Yes
No

Section 3 — Other/Opposing Party Information

Please provide as much information as you know about any other or opposing party involved in this matter. If you do not know the information, you may leave the applicable fields blank.

Date of birth
Month
Day
Year
Are there additional people involved in this matter?
Yes
No

If applicable, please list the names and any information you know about additional people involved in this matter.

Section 4 — Criminal Matter Information

How is your charge classified?
Misdemeanor
Felony
Unsure
What type of criminal matter is this?
Traffic
DUI/DWI
Probation Violation
Protective Order Related
Juvenile Matter
Other

Please list all known charges. If you are unsure of the exact charge, provide as much information as you know.

Section 5 — Arrest and Incident Information

Were you arrested?
Yes
No

Complete only if you were arrested.

Section 6 — Court Information

Do you have an upcoming court date?
Yes
No

Complete if you have an upcoming court date.

What court?

Section 7 — Brief Description

Section 8 — Legal Benefit Plan

Do you have a legal benefit plan?
ARAG
MetLife
CLC
None
Unsure

Section 9 — Acknowledgments

bottom of page