Stephanie L Schneider, P.A. Board Certified Elder Law Attorney in Florida.

	1860 North Pine Island Road, Suite 111 Plantation, Florida 33322 Phone: (954) 382-1997 Fax: (954) 382-9997 HOME

	Schedule an Elder Law Consultation
	Schedule an In-Service or Presentation

Schedule an Elder Law Consultation

Call our Office to Schedule a Consultation Today
954-382-1997

Preparing for Your Consultation:

Welcome to our office. When you contact our office to schedule a consultation you will speak with a Client Liaison.

Our Client Liaison will:
- Ask you specific questions about your legal issue so that we can properly identify your legal needs.
- Schedule sufficient time for your initial consultation.
- Provide you with our qualifications.

Our Client Liaison will mail you a package that contains:
- A confirmation letter
- Directions to our office; and
- A Questionnaire and Exhibit List. If you would like to print out these documents please ask our Client Liaison which documents you should print for your personalized consultation.

You will need to:
- Complete the mailed or emailed questionnaire before your consultation in order for us to help you meet your goals.
- Review the Exhibit List which is enclosed with your questionnaire and bring the documents listed on it to the
appointment.
- Bring a Driver’s License or Government approved photo identification to your consultation.

If you have difficulty filling out the questionnaire completely, please notify us. You may come to the office 1 hour prior to your appointment for assistance in filling out the form (at no charge). If the questionnaire is incomplete and you do not arrive early, you will be charged when your appointment is scheduled to begin. Please arrive at least 15 minutes before your appointment so documents can be copied.

We invite you to make a list of questions and concerns you would like to discuss and bring it with you to the appointment. Your appointment is a “working consultation” where your questions will be addressed, possible alternative legal solutions identified, and the applicable laws will be discussed.

Please complete this web form so that our Client Liaisons can call you to schedule an appointment. Our Client Liaisons will explain to you the cost and benefits of the consultation and what it includes. You may submit this web form online by completing the fields below and hitting the 'Submit" button at the bottom, or click here to open up a PDF document that you can print and fax to us at (954) 382-9997 . Alternatively, we invite you to call our Client Liaisons at (954) 382-1997. Please note that WE DO MAKE HOUSE CALLS and can schedule a telephone consultation if you are out-of-state or in another area of Florida.

YOUR NAME : *

YOUR ADDRESS: *

YOUR PHONE: *

YOUR FAX:

WHO REFERRED YOU?

RELATIONSHIP TO PERSON FOR WHOM YOU ARE CALLING:

ADDRESS OF PARENT/RELATIVE:

PHONE NUMBER OF PARENT/RELATIVE:

MARITAL STATUS: Single Married

AGE:

VETERAN: (WIDOW/ER OF VETERAN) YES NO

TYPE OF MATTER : (Check all that apply)

A. ESTATE PLANNING	E. PROTECTION of P.I. SETTLEMENT
B. MEDICAID PLANNING	F. TRUST ADMINISTRATION
C. GUARDIANSHIP	G. OTHER:
D. PROBATE

IS THE PERSON YOU ARE CALLING ABOUT COMPETENT? YES NO

IS THE PERSON YOU ARE CALLING ABOUT ILL? YES NO

To best prepare for a consultation, please provide the following:

DO YOU OWN: Home Securities

Other Assets

DO YOU RECEIVE: Social Security Pension

Other Income

DO YOU HAVE ANY OF THE FOLLOWING LEGAL DOCUMENTS?:

Last Will & Testament	Designation of Healthcare Surrogate	Living Will
Durable Power of Attorney	Revocable Living Trust

IS THIS AN EMERGENCY? YES NO

IS PERSON IN HOSPITAL? YES NO ( IF YES, NAME OF HOSPITAL )

IS PERSON BEING DISCHARGED FROM HOSPITAL? YES NO

ARE ANY OF THE FOLLOWING SITUATIONS APPLICABLE?

A. PERSON DIED AND THERE IS BURIAL PROBLEM

B. PERSON IS IN MENTAL HEALTH FACILITY

NAME OF FACILITY

C. PERSON WAS BAKER ACTED

NAME OF FACILITY

D. PERSON BEING DISCHARGED FROM NURSING HOME

NAME OF FACILITY

ADDITIONAL COMMENTS OR CONCERNS:

* Required