Attorney Request Form

First Name *

Last Name *

Phone *

Email

Address 1

Address 2

City *

State *

-- select --AlabamaAlaskaAlbertaAmerican SamoaArizonaArkansasArmed Forces-AAArmed Forces-AEArmed Forces-APBritish ColumbiaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineManitobaMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew BrunswickNew HampshireNew JerseyNew MexicoNew YorkNewfoundland and LabradorNorth CarolinaNorth DakotaNorthern Mariana IslandsNorthwest TerritoriesNova ScotiaNunavutOhioOklahomaOntarioOregonPennsylvaniaPrince Edward IslandPuerto RicoQuebecRhode IslandSaskatchewanSouth CarolinaSouth DakotaTennesseeTexasUnited States Minor Outlying IslandsUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingYukon Territory

Zip/Postal Code *

Type of Attorney Needed

-- select --Admiralty/Maritime LawAviationBusiness - CorporateBusiness - Corporate BankruptcyBusiness - FinanceBusiness - GeneralBusiness - Liquor LicenseBusiness - Non-Profit CorporationsBusiness - Patent/Copyright/TrademarkCivil RightsCollectionsComputer LawConsumer Protection/Identity TheftContractsCriminal - AppealsCriminal - ExpungementCriminal - GeneralCriminal - JuvenileEmployment and Labor LawEntertainment LawFamily LawGovernmentHIPPAInsurance - AutomobileInsurance - GeneralInsurance - Home/Fire/PropertyInsurance - Life/BenefitsInsurance - Major Medical/HospitalizationInsurance - Medicare/MedicaidLandlord/Tenant IssuesLemon LawMalpractice - LegalMalpractice - MedicalMalpractice - PharmaceuticalMalpractice - VeterinaryNursing HomePersonal Finances - BankruptcyPersonal InjuryProbate - AdoptionProbate - EmancipationProbate - Estate PlanningProbate - Guardianship/ConservatorshipProbate - Mental HealthProbate - Wills and TrustsReal EstateSchool LawSenior CitizensSocial SecurityTaxesTraffic/License Restoration/OUIL/DWI

Provide a brief summary of legal situation *

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How did you hear about the OCBA Lawyer Referral Service?

-- select --Another AttorneyCity OfficeCourt -Bankruptcy CourtCourt - Oakland County Circuit CourtCourt - Oakland County District CourtCourt - OtherEEOCFamily/FriendInternet - Google SearchInternet - Michigan Legal HelpInternet - OCBA WebsiteInternet - OtherInternet - YellowPages.comInternet - YelpLaw LibraryLegal Aid and Defender/Family Law Assistance ProjectLegal Aid ClinicMedia Outlet (Newspaper, TV, etc.)Phone BookProsecutor's OfficeSocial Security AdministrationState Bar of MichiganUAWUnited Way (211)Used BeforeOther...

How would you like us to respond to your request? *

• Phone
• Email

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