Request a Consultation

If you are not currently a client,please read our consultation policy, then enter the information below so
that we may contact you for a consultation. Thank you.

 

Your last name (per passport): Your first name (per passport): Your middle name (per passport): Your e-mail address:

Gender: Male  Female

Date of birth (must be mm/dd/yyyy):

Country of birth:

Country of citizenship:

Marital status: Single    Married   Divorced   Widowed   Separated   Common-Law   Engaged

Work phone:

Home phone:

Cell phone:

Address line 1:

Address line 2:

Apartment #:

City:

State:

Postal Code:

Country:

I-94 expiration (must be mm/dd/yyyy):

Current immigration status:

Status expiration (must be mm/dd/yyyy):

Briefly describe your immigration situation:

 

By submitting the consultation form, you are  asking Jackson & Hertogs LLP to consider your legal question or  issue. Submitting the consultation form does not, however, constitute an agreement for representation or obligate Jackson &  Hertogs to take any action on your behalf. Jackson & Hertogs cannot represent you in any matter unless you and Jackson & Hertogs expressly agree, in writing, that it will serve as your counsel.

Jackson & Hertogs will maintain the privacy of this information.  We will seek to protect your identity, as well as any  confidential information that you provide, from disclosure,  publication, or other use that you do not authorize to the  extent that it can under the law. We will not in any manner sell  your e-mail address or personal information.

Jackson & Hertogs cannot represent you in any matter unless you  and Jackson & Hertogs expressly agree, in writing, that it will serve as your counsel. Please note that reading this website, or  receiving information from it, does not create a contract for our services.  Likewise, sending an e-mail message to  Jackson & Hertogs does not, by itself, create a contract for our services. Nor will reading this website give rise to such a  contract.

|