Business & Commercial Litigation Intake Questionnaire

Contact Information

Please provide your contact details so we can reach you regarding your matter.

Full Legal Name *

Business/Entity Name (if applicable)

Street Address *

City *

State *

ZIP Code *

Phone Number *

Email Address *

Preferred Contact Method *

Best Time to Reach You *

How Did You Hear About Us? *

Breach of Contract Details

Provide information about the contract at issue and the alleged breach.

Type of Contract

Written

Oral

Both Written and Oral

Date of Contract

Parties to the Contract

Brief Description of Contract Terms

What Obligation Was Breached?

Date Breach Occurred or Was Discovered

Attempts to Resolve (Demand Letters, Negotiations, Mediation)

Damages Sought or Claimed Against You

Estimated Amount in Controversy

Do You Have a Copy of the Contract?

Yes

Business Torts & Unfair Trade Practices

Describe the alleged wrongful conduct and its impact on your business.

Nature of the Claim (Select All That Apply)

Tortious Interference

Louisiana Unfair Trade Practices Act (LUTPA) Violation

Fraud/Misrepresentation

Conversion

Detrimental Reliance

Unjust Enrichment

Other

Describe the Wrongful Conduct

When Did the Conduct Begin?

When Did It End?

When Did You Discover the Conduct?

Identify the Parties Involved and Their Relationship to You

How Has This Affected Your Business?

Estimated Financial Damages

Have You Reported This Conduct to Any Government Agency?

Yes

Which Agency and Details

Prior Legal Action & Related Matters

Tell us about any prior attorney consultations, related disputes, or insurance coverage.

Have You Consulted Another Attorney About This Matter? *

Yes

Attorney Name

Outcome/Result

Is This Dispute Related to Any Other Pending Legal Matter? *

Yes

Describe the Related Matter

Have You Been Involved in Any Prior Lawsuits Related to This Dispute? *

Yes

Describe the Prior Lawsuits

Is There Any Insurance Coverage That May Apply to This Matter? *

Yes

Insurance Carrier

Policy Number

Conflicts Check

This information helps us determine whether any conflict of interest exists that would prevent us from representing you.

List All Parties Involved in This Dispute *

We must check for conflicts against all parties before evaluating your case.

Have You Ever Been a Client of Aertker Legal, LLC? *

Yes

If Yes, Describe the Prior Matter

Do You Have Any Known Connection to Aertker Legal, LLC or Its Attorneys?

Additional Information & Submission

Please share any additional documents and information that will help us understand your matter.

Key Documents You Have Available

List any documents available for our review. Copies can be provided separately.

Anything Else You Want Us to Know?

How Urgently Do You Need Assistance? *

I certify that the information provided in this questionnaire is true, accurate, and complete to the best of my knowledge. I understand that this questionnaire does not create an attorney-client relationship, and that no legal advice has been provided. An attorney-client relationship is not established until a written engagement agreement has been signed by both me and the firm. I authorize Aertker Legal, LLC to contact me regarding my inquiry and to gather additional information as necessary to evaluate my matter. I understand that I should preserve all documents, communications, and evidence related to this dispute — including contracts, emails, text messages, invoices, financial records, and electronic data — and should not destroy, delete, or alter any potentially relevant materials. *

Supporting Documents (optional)

Attach up to three documents relevant to your matter — for example an existing will, deed, contract, police report, or correspondence. PDF, Word, or image. You may bring or email additional documents to your consultation.

Maximum ~10 MB. For larger or highly sensitive files, please bring them to your appointment.