LegalGEN - Home

Registration Info
Please use your legal name as it appears on your license or government-issue ID

Get started, provide your information below and provide your Child's info on the next page

First Name *

Middle Name

Last Name *

Email *

Password *

Cell *

Young Adult Info
Please provide the name of your college student. You are filling this out for them; their name will be selected as the primary” in the document while you can provide your name as their agent.

Are you a parent filling this out for your college student?

✓

Yes

✓

No

Student Name

Your Contact Details
Your Contact Details

Name:

Date Of Birth *

Also known as(optional)

Are you married?

✓

Yes

✓

No

Suffix(optional)

✓

Jr

✓

Sr

✓

II

✓

III

✓

Other

What are your personal pronouns?

✓

he/him

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she/her

✓

they/them

Your Address

Full Address: *

Address Line 1 *

Address Line 2

City *

State *

County *

Zip Code *

Is Your mailing address the same as your home address?

✓

Yes

✓

No

Your Spouse Information
Please use your legal name as it appears on your license or government-issue ID

Your spouse's Details

First Name: *

Middle Name *

Last Name: *

Email *

Date Of Birth *

Cell *

Suffix(optional)

✓

Jr

✓

Sr

✓

II

✓

III

✓

Other

Also known as(optional)

What are your spouse's pronouns?

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he/him

✓

she/her

✓

they/them

Is Your spouse's address different than you?

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Yes

✓

No

State: *

Financial DPOA:
Name someone (agents) you trust to make financial decisions on your behalf in the event you are unable to do so yourself.

Provide the information of one or more individuals who will serve as your agent under the Durable Power of Attorney:

Primary Agent: *

Phone Number *

Address *

Health Care POA
Name someone (agents) to make medical decisions on your behalf in the event that you are unable to make those decisions for yourself

Please provide the information of one or more individuals who will serve as your health care agent:

Do you wish to use the same agents as your Financial Durable POA?

✓

Yes

✓

No

Primary Agent: *

Phone Number *

Address *

Health Care POA - Spouse/Partner
Name someone (agents) to make medical decisions on your behalf in the event that you are unable to make those decisions for yourself

Please provide the information of one or more individuals who will serve as your health care agent:

Do you wish to use the same agents as your Power of Attorney?

✓

Yes

✓

No

Primary Agent: *

Phone Number *

Address *

Summary
Summary

If you would like to review your responses, please review your responses on the right hand side on the specific screens. After you click submit, you will be finished and we will email your answer and the office will contact you with the next steps .

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