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2. Legal Clinic Information This section is complete This section is incomplete
3. Disclosure Statement This section is complete This section is incomplete

General Information

Washington County Legal Advice Clinic Intake Form
Clinic Services are available to litigants with cases pending in Washington County. Complete this entire form, and sign the Disclosure Statement. It is very important that you bring any court orders or court documents to the clinic so the attorney can review your case and give you correct legal advice. Once you submit your form, a law librarian will contact you and schedule an appointment.
Court File Number (if Applicable)
Your Information
First Name*
Last Name*
Phone Number*
Other Party's Information (Required)
Name (Person or Business)*
Previous Name/Maiden Name
Does the other party in this case have legal representation?*
If yes, by whom?
Do you have legal representation for this issue?*
1. Yes
1. No
The Minnesota Rules of Professional Responsibility states Rule 4.2: “In representing a client, a lawyer shall not communicate about the subject of the representation with a person the lawyer knows to be represented by another lawyer in the matter, unless the lawyer has the consent of the other lawyer or is authorized to do so by law or a court order.”
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Disclosure Statement*
- I understand that the volunteer attorney is providing only limited advice and information and does not represent me in my case. The attorney will not be my attorney of record or go to court with me.
- I certify that my annual family income is less than 350 percent of the 2024 Federal Poverty Guidelines.
- I understand that I remain responsible for all aspects of my legal matter.
- I understand that a student or library staff may be present at the clinic to aid in the process and that person will not be providing legal advice.
- I understand that the Washington County Law Library is hosting the clinic and that they do not endorse the volunteer or is not liable for the legal advice or assistance given.
- By typing my name below, I have read and agreed to the terms above, and my typed name will be considered an electronic signature.
1. I certify that I have read and understand this disclosure statement, and I agree to the terms listed above.
Tennessen (Data Privacy) Notice*
Please review Washington County Library's Tennessen Warning before submitting this form. The Tennessen Warning outlines how we will use the data you provided in this form.
1. Please check the box to acknowledge that you have read and accepted the contents of the Tennesen Warning.
First Name*
Last Name*

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