Intake Form

Application for Legal Services

Welcome to North Georgia Legal Aid’s online application. Please note that submitting an application does not guarantee that you will be selected for services. Your application will be reviewed in the order it is received, and there may be a wait before an intake worker can respond. If you have an urgent legal issue, such as a pending court date or an immediate deadline, please contact our office directly as soon as possible. If you qualify for assistance, a lawyer may provide you with legal advice or possibly represent you. In some cases, we may refer you to other programs, such as volunteer attorney services or local bar association referrals. However, please be aware: Due to limited funding, our services may be limited to advice only. The advice given should not be considered a binding legal decision or obligation. North Georgia Legal Aid is not liable for any outcomes based on the advice or services provided. Selection for services is at our sole discretion and based on our funding, regulations and policies.

Suffix

Address

Address where legal assistance is needed(Required)

Check the box if we may leave a message at your number.

Primary Phone No(Required)

Secondary Phone No

Best time to call?(Required)

Other Information

Primary Email Address(Required)

Secondary Email Address

Date of Birth(Required)

Gender(Required)

Marital Status(Required)

Opposing Parties

List the people or businesses, if any, you are having trouble with. Use the + button to add more if needed.

Party Type

First / Business Name

Last / Business Type

Financial Information

We need to know financial information about your household to determine if we may be able to help you. Enter income for everyone in your household. Household Income:(required) You must pick at least one income type, or pick 'No Income'

Type of Income(Required)

Frequency(Required)

Amount $(Required)

Describe Your Problem

We need to know financial information about your household to determine if we may be able to help you. Enter income for everyone in your household. Household Income:(required) You must pick at least one income type, or pick 'No Income'

Select your main legal problem(Required)

Please give us some details about this legal problem, and any others you may need assistance with.(Required)

Signature