This Authorization to Obtain Employment Information is given by a client to an attorney in order to obtain information regarding client’s employment. This authorization sets forth the specific information which can be given including amounts paid to employee under a sick leave policy and other financial benefits. This Authorization to Obtain Employment Information is valid for one year from the date of signing.
This Authorization to Obtain Medical Records and Billing Information is sent by an attorney to a physician’s office in order to obtain a client/patient’s medical and billing information. This authorization is signed by the client and sets forth the dates of treatment for which the records are being sought. This Authorization must be signed and dated by the client/patient as it remains in effect for one year from the date of signing.
This Contingency Fee Agreement is between an attorney and a client setting forth the specific terms of a contingency fee arrangement. This agreement sets out specific legal services to be provided, the percentage amount the attorney will receive in certain scenarios of recovery and an authorization of settlement. This Contingency Fee Agreement also contains provisions regarding costs, attorney’s lien, attorney discharge or withdrawal. This Contingency Fee Agreement must be signed by both the client and the attorney.
This General Claim Form sets out the specifics of an insurance claim. This form contains the name of policy holder, policy number and agency, amount insured and insurance period. Specifics regarding the claim include date and time when loss or damage occurred, where the loss occurred, by whom the loss was discovered and any particulars on how the loss or damage occurred. This form is signed by the insured who declares that the information provided is true and accurate.
This Hourly Fee Agreement is between an attorney and a client which sets forth the hourly rates of any attorneys who will provide services on the client’s behalf. This arrangement sets out in detail the specific services to be performed, the responsibilities of both attorney and client and how costs will be paid. This Hourly Fee Agreement must be signed by both the client and the attorney.
This Intake Form used by an attorney when first interviewing a prospective client. This form contains all pertinent information about the client including all contact and insurance information. This Intake Form also includes information regarding other attorneys who were consulted, legal notices received, identity of any witnesses, relevant case documents and how the client chose the attorney.
This Letter Declining Client Representation is from an attorney to a prospective client and sets forth the reason why the client’s case is being declined. This declination letter also instructs the client to seek other representation and sets out how any original documents will be returned to client.
This Letter to Adverse Insurance Company is from an attorney informing an insurance company that a client is now represented by an attorney regarding a specific accident claim. This letter sets out the name of the client, claim number, the insured’s name and date of the accident. This Letter to Adverse Insurance Company also encloses copies of the police report of the accident and client’s medical records and medical bills.
This Letter Withdrawing from Representation is from an attorney to a client in which the attorney withdraws from representing the client. This letter sets forth the specifics of the client’s case and the reasons for withdrawal. This Letter Withdrawing from Representation also sets forth attorney’s cooperation in transferring the client’s files and documents to another lawyer.
This Notice of Legal Representation is from an attorney to another party on a client’s behalf. This notice effectively sets forth that client is now represented by an attorney. This notice gives the name of the attorney, the address, state where licensed to practice and specific client case information.
This Referral Agreement is between a company and a referring party who will provide exclusive services to the company. This agreement sets out the exact services to be provided, standards of performance, term of the agreement and the independent contractor status of the referring party. This Referral Agreement also contains a provision regarding confidential information and must be signed by both company and referring party.
This Request for Case Update is a written communication from a client to an attorney requesting an update about client’s pending case. This letter sets out the parties to the case and case number and also asks that an update be provided at the earliest convenience.
This Settlement Disbursal Sheet is a detailed statement of a net payment to a client once an attorney has settled a case. This Settlement Disbursal Sheet contains the amount of total settlement, attorney fees, costs for medical records, copies, police reports, other miscellaneous payments made by attorney and the total net payment to the client.