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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

Criminal Law Intake Form

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

Client Information

Date of birth
Month
Day
Year

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

Criminal Matter Information

What type of criminal matter is this?

Arrest and Incident Information

Were you arrested?
Yes
No

Charges

Court Information

Do you have an upcoming court date?
Yes
No

Brief Description

Legal Benefit Plan

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

Preferred Contact Method

Preferred contact method
Phone
Email
Text Message

Acknowledgments

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