Estate Planning Needs Evaluation Form

Name: *
Address:
City:
State:
Zip Code:
Email: *
Home Telephone:
Business Telephone:
Cell Phone:
Fax Number:
What is your relationship to the person planning as estate?
Name of person planning an estate: (if different from above):
Address:
City:
State:
Zip Code:
Email:
Home Telephone:
Business Telephone:
Cell Phone:
Fax Number:
Does the person have a will? Yes No Don't Know
Does the person have a revocable living trust? Yes No Don't Know
Does someone have general power of attorney for the person? Yes No Don't Know
Does someone have medical power of attorney for the person? Yes No Don't Know
Does the person have a living will? Yes No Don't Know
Does the person have a guardian or conservator? Yes No Don't Know
Does someone feel that the person needs to assign a guardian or conservator? Yes No Don't Know
What is the person's marital status?
Does the person have dependent children? Yes No
Has the person asked for your assistance in finding estate planning counsel? Yes No
Where did you hear about this website?

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Quick Contact

In order to help you more quickly, please fill out the quick form and submit or call 703.491.6400. A representative of the firm will call you ASAP.

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