Welcome to Fadelylaw
Thank you for using our Digital Intake Form. Our firm collects this information to ensure you are meeting with the right team and gives us a head start on understanding your unique situation. By providing as much information as possible prior to your appointment, it allows us to make the best use of our time together during your first appointment. All information asked is optional and you only need to share information you are comfortable with disclosing. Additional details can be discussed during your appointment. Please select the reason for meeting with our office. If you are not sure, please select Other and add a brief note about why you contacted our office. By knowing what is most important to you, it helps our firm better prepare to answer your questions.
Thank you for visiting our Digital Intake.

Have you met with our office before?
Yes
No

Applicant Information
Please let our office know if you are completing this intake for yourself or a loved one. If for a loved one, please indicate your relationship to the applicant. By providing our office with information regarding any health issues, it helps us to get an understanding of what care may be needed in the future or possible benefits you may be eligible to receive. If you are interested in special needs planning, please do not complete this intake with information for the child or beneficiary with a special need. The person that would like to set up planning for the person with a special need should complete this section. There will be a section to add information on the person with a special needs later in this intake.
Are you filling this out for yourself or for your loved one?
For a Loved One
For Myself
Do you have any health issues?
Yes
No
Are you/the applicant currently in a rehab, hospital or nursing home?
Yes
No


General Information
Please answer yes or no to the questions on this page.
Are you/the applicant a veteran?
Yes
No
Do you/the applicant have any estate planning documents (Will, POAs, Trusts)?
Yes
No
Do you/the applicant have any children?
Yes
No

Information
If you are completing this form for yourself, please enter your information and, if applicable, your spouse’s information. If you are completing this form for a loved one, please enter their information and spouse’s, if applicable, and your information.
Applicant Information
*

*

*

*

*

Is the applicant married?
Yes
No
Suffix(optional)
Jr
Sr
II
III
Other
What are your personal pronouns?
he/him
she/her
they/them
*

*

*

*
*

*

Is Your mailing address the same as your home address?
Yes
No

Total Estate Size
When determining your total estate size, please include the approximate value of any real estate, bank accounts, investment accounts, retirement accounts, businesses, and other assets. Please do not include the death benefit of any life insurance. If you do not know this information, please select your best estimate. This information is only used to match you with the best team for your estate planning. We do request more specific asset information on the following pages. It is recommended that you add this additional asset information, but it is not required. By providing this additional information now, we can ensure your time spent speaking with our office during your appointment is as productive as possible.
*

Real Estate
Please provide information regarding the assets you own. This information helps our firm to understand the size of your estate, where your assets are held, debts you may owe, and any business interests. All these factors affect the planning and recommendations that our firm provides for you. It is important to provide as much information as possible. If you do not know exact figures, please enter your best estimate or “unknown.” If you are not sure of any asset information, please make a note at the end of this form and we can discuss further during your first appointment.
Do you/the applicant own a home?
Yes
No

Assets Information
Please provide information regarding the assets you own. This information helps our firm to understand the size of your estate, where your assets are held, debts you may owe, and any business interests. All these factors affect the planning and recommendations that our firm provides for you. It is important to provide as much information as possible. If you do not know exact figures, please enter your best estimate or “unknown.” If you are not sure of any asset information, please make a note at the end of this form and we can discuss further during your first appointment.
Do you/the applicant own any checking or savings accounts?
Yes
No
Do you/the applicant own any retirement accounts?
Yes
No
Do you/the applicant have any outstanding debt besides a mortgage?
Yes
No

Assets Information Continued
Please provide information regarding the assets you own. This information helps our firm to understand the size of your estate, where your assets are held, debts you may owe, and any business interests. All these factors affect the planning and recommendations that our firm provides for you. It is important to provide as much information as possible. If you do not know exact figures, please enter your best estimate or “unknown.” If you are not sure of any asset information, please make a note at the end of this form and we can discuss further during your first appointment.
Do you/the applicant own any investment or non-retirement accounts?
Yes
No
Do you/the applicant own a business?
Yes
No
Do you/the applicant own any life insurance policies?
Yes
No
Do you work with a financial advisor?
Yes
No
Do you have any additional information to share or comments that would be helpful to know about your assets?
Yes
No

Monthly Income
Please provide your monthly income information on this page. By knowing your monthly income, it helps our firm know what types of benefits you may be eligible for.
Please add your/the applicant’s income information for any applicable sources.

Currently Employed?
Yes
No

Is your spouse currently Employed?
Yes
No

Additional Information


Referral Information
We are so happy you found us, and we would like to know where you learned about our firm. This information helps us to ensure we are marketing in the correct areas and thanking our referrals. All client information is kept confidential when sending thank you notes.
How did you learn about Beacon Legacy Group?
*


Submission Screen