Divorce Appointment Form

BAILEY & GALYEN ATTORNEYS AT LAW
  • First Name*
  • Last Name*
  • Middle Name
  • Maiden Name
  • Date of Birth*
  • Male/Female*
  • County of Residence
  • Address*
  • Home Phone Number
  • Cell Phone Number
  • Work Phone Number
  • Email Address
  • Spouse

  • Spouse's First Name*
  • Spouse's Last Name*
  • Spouse's Maiden Name
  • Spouse's Date of Birth*
  • Spouse's Address (if different from yours)
  • Marriage Information

  • Date of Marriage
  • Date of Separation
  • Children

  • Child 1
  • Full Name
  • Male/Female*
  • Date of Birth
  • Where does the child reside?
  • With Who?
  • For how long?
  • Child 2
  • Full Name
  • Male/Female*
  • Date of Birth
  • Where does the child reside?
  • With Who?
  • For how long?
  • Child 3
  • Full Name
  • Male/Female*
  • Date of Birth
  • Where does the child reside?
  • With Who?
  • For how long?
  • Property of Parties

  • Is your property already divided by agreement?
  • Are you buying or do you own a home?
  • Does either party have retirement benefits/stocks of any kind?
  • Is there a Prenuptial Agreement?
  • Name Change Request

  • Are you requesting the Court to grant a name change?
  • New Full Name Requested
  • Case Related

  • Has a divorce been filed anywhere?
  • Have you been served papers?
  • Has there been any family violence in the past 2 years?
  • Has your spouse ever been charged with any crime other than traffic tickets?
  • Have you ever filed Bankruptcy?

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