Estate Planning Consultation Form

Client

Full Legal Name

Other Name

Street Address

Email Address

Date of birth

Phone Number

Secondary Phone Number

US citizen?

Are you married?

Co-Client

Full Legal Name

Other Name

Street Address

Email Address

Date of birth

Phone Number

Secondary Phone Number

US citizen?

Children

Children count

Children Info

All Children Health

Is anyone receiving SSI or SSDI?

Do any children have any of these issues?

Debt Information

Child Exclusion

Selecting Beneficiaries

Spousal Wishes Note

First-choice of beneficiary or beneficiaries

Second choice of beneficiary or beneficiaries

Third choice of beneficiary or beneficiaries

Residence Disposition

Special Gifts

Selecting Fiduciary

Client: Will Selections

Client: Trust

Client: Guardian

Client: Financial POA

Client: Health Care POA

Co-Client: Will Selections

Co-Client: Trust

Co-Client: Guardian

Co-Client: Financial POA

Co-Client: Health Care POA

Closing Information

Additional Information

Identity Verification

Full Legal Name (Client*)

* This is the person that we are drafting the documents for. It could be you, or it could be the person you’re filling the form for. First name: Last name: As it appears on your government issued ID.

Other Name (Client)

Please list any other legal names that you go by

Street Address (Client)

Street

City

State/Province

Zip/Postal Code

Country

Email Address (Client)

Date of birth (Client)

Phone Number (Client)

Format: +1234567890

Secondary phone number

Format: +1234567890

US citizen? (Client)

Are you married or is there a secondary co-client?

Full Legal Name (Co-Client)

First name: Last name: This is your spouse’s or co-client’s information

Other Name (Co-Client)

Please list any another legal names that you go by

Street Address (Co-Client)

Street

City

State/Province

Zip/Postal Code

Country

Email Address (Co-Client)

Date of birth (Co-Client)

Phone Number (Co-Client)

Format: +1234567890

Secondary phone number

Format: +1234567890

US citizen? (Co-Client)

How many children you have?

Are all of your children in good health?

Are any receiving SSI/SSDI?

Do any children have any of these issues?

Serious physical or mental illness? Drug Addiction? Alcoholism? Debt problems/ bankruptcy? Marital Difficulty?

Have you given any children any gifts or would you like to include any loans you’ve made to any children in your estate plan?

Are we going to be excluding any children from your plan?

Do you have any spousal arrangement that you’d like included in your estate plan?

For example, have you signed a prenuptial or postnuptial agreement?

First choice of beneficiary or beneficiaries:

Others

The beneficiary is the person or persons that will be inheriting your assets

Second choice of beneficiary or beneficiaries:

Others

We always have a backup beneficiary....just in case

Third choice of beneficiary or beneficiaries:

Others

You never know…

Any specific disposition of your residence?

Any specific gifts of special items?

You will have an opportunity to work on a list of tangible items at your leisure, don’t stress about this section

Last Will and Testament Personal Representative (the Executor of your Estate)

Name of your Primary Personal Representative
Name of your backup (successor) Personal Representative

Agent Cooperation:

You can pick one person or persons or you can pick two or more people.

Trustee of any trust that you and I work on (should you need or want a trust pending our consultation meeting).

Name of your Trustee:

You can pick one person or persons or you can pick two or more people.

Legal Guardian of any minor children. Who will raise the children on your behalf

Name of your Guardian:

Power of Attorney is the person that will make FINANCIAL decisions on your behalf should you not be able to make them for yourself.

Name of your Primary Power of Attorney Agent
Name of your Backup (Secondary) Power of Attorney Agent

Agent Cooperation:

You can pick one person or persons or you can pick two or more people.

Health Care Proxy is the person that will make HEALTH related decisions on your behalf should you not be able to make them for yourself.

Name of your Primary Health Care Proxy
Name of your Backup (Secondary) Health Care Proxy

Agent Cooperation:

You can pick one person or persons or you can pick two or more people.

Last Will and Testament Personal Representative (the Executor of your Estate)

Name of your Primary Personal Representative
Name of your backup (successor) Personal Representative

Agent Cooperation:

You can pick one person or persons or you can pick two or more people.

Trustee of any trust that you and I work on (should you need or want a trust pending our consultation meeting).

Name of your Trustee:

You can pick one person or persons or you can pick two or more people.

Legal Guardian of any minor children. Who will raise the children on your behalf

Name of your Guardian:

Power of Attorney is the person that will make FINANCIAL decisions on your behalf should you not be able to make them for yourself.

Name of your Primary Power of Attorney Agent
Name of your Backup (Secondary) Power of Attorney Agent

Agent Cooperation:

You can pick one person or persons or you can pick two or more people.

Health Care Proxy is the person that will make HEALTH related decisions on your behalf should you not be able to make them for yourself.

Name of your Primary Health Care Proxy
Name of your Backup (Secondary) Health Care Proxy

Agent Cooperation:

You can pick one person or persons or you can pick two or more people.

Any other information you would like to provide

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Identity Verification

📁 Add Files (Max 10MB per file, allowed formats: PDF, JPG, PNG)

Your ID upload is encrypted and securely stored. We use industry-standard security measures to protect your personal information.

You did it! We’ll review everything and fill in any blanks during our consultation. This is great!

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