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Family Law

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Intake Form

Please fill out the intake form below to tell us about your legal situation

Lets get started

Intake Form

Please fill out the intake form below to tell us about your legal situation.

Get started with Cooper Law by submitting an online intake form to give us more information about your legal situation. After you fill out the form, potential social security clients will receive a call within 2 business days to schedule a consultation.

Potential family law clients will be directed to our calendar to schedule a free 15-minute phone consultation with our intake specialist.

Cooper Law Online Intake Form

Use this form for the initial online intake if you are looking for family law representation or social security disability representation. After you fill out and submit the form, you can schedule yourself for a 15 minute free consultation to determine if your legal matter is a good fit for Cooper Law, LLC.

Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email
How did you hear about Cooper Law, LLC?*
What is your legal issue?*
- Family Law (Dissolution, divorce, custody, parenting time, support)
- Social Security Disability
- Other
Are you calling to apply for social security for your child?*
- Yes
- No
What is the child's name?
First Last
What is your date of birth?*
MM slash DD slash YYYY
How old are you?*
Are you currently receiving Social Security benefits?*
- Yes
- No
Do you have an attorney representing you for your social security disability claim?*
- Yes
- No
Have you already filed for social security disability?*
- Yes
- No
Do you have a hearing scheduled in front of a judge for your social security claim?
- Yes
- No
What is the date of the hearing?
Have you received a decision on your social security claim?
- Yes
- No
Did you go to a hearing in front of a judge within the past six months and the decision you received is the judge's decision?
- Yes
- No
Was the decision a denial of your claim for disability?
- Yes
- No
What is the date on the denial of your claim?
Do you have a copy of the letter from social security denying your claim?
- Yes
- No
Do you expect to be unable to work for at least 12 months?*
- Yes
- No
Are you currently working?*
- Yes
- No
If you are currently working, how much are you being paid per hour?*
If you are currently working, approximately how many hours per week are you working?*
If you are NOT currently working, when was the last time you worked?
Why did you stop working?
Are you receiving treatment from a doctor for your disability?*
- Yes
- No
What is the medical reason or condition that makes you unable to work?*
Check all public benefits you are receiving (if any):*
- Diversionary Work Program (DWP)
- General Assistance (GA)
- Group Residential Housing (GRH)
- Minnesota Family Investment Program (MFIP)
- Refugee Cash Assistance (RCA)
- Title IV-E Foster Care
- None of the above
Do any of the following apply to you? (Check all that apply)*
- I iive on the street
- I live outdoors
- I live in an abandoned/condemned building
- I live in a shelter that provides temporary living accommodations
- I am in a doubled-up living arrangement where my name is not on the lease
- I live in a boarding house
- I have received an eviction notice
- I live in a halfway house or residential treatment program
- My rent or utilities are in arrears
- I am living in transitional housing
- I am a youth transitioning out of foster care
- I am being discharged from an institution or correctional facility without a place to liv
- None of the above
Hidden
Does any of the following apply to you? (Check all that apply)
Homeless is defined as: an individual who is living outdoors, on the street, in an abandoned/condemned building, or in a shelter that provides temporary living accommodations.

At-risk of homelessness is defined as: an individual who is in a doubled-up living arrangement where the individual's name is not on the lease, boarding house, eviction notice, halfway house, residential treatment program, rent or utilities in arrears, transitional housing, or youth transitioning out of foster care, or being discharged from an institution or correctional facility without a place to live.

Permanent supportive housing is defined as: living in supportive housing that is designated for individuals who have experienced homelessness.
- I am currently homeless
- I am currently at risk of homelessness
- I am living in permanent supportive housing
- None of the above
Hidden
What is the Minnesota county you currently live in or where you spend most of your time?
- Hennepin
- Ramsey
- Anoka
- Dakota
- Washington
- Other
Do you have a case manager or other person who helps you fill out paperwork?*
- Yes
- No
What is the name and phone number of your case manager or person who helps you with paperwork?*
What are the issues in your legal case?*
Check all that apply.
- Divorce
- Legal Separation
- Child Custody
- Parenting Time
- Child Support
- Spousal Maintenance
- Division of Property
- Custody of a Child that is not my own
- Domestic Abuse
- Child Protection Defense
- Other
What is the name of the opposing party in your case?*
First Last
Does the opposing party have an attorney?*
- Yes
- No
- I don't know
What is the name of the attorney for the opposing party?
First Last
Are you currently represented by an attorney?*
- Yes
- No
Have you been served with any legal papers recently?*
- Yes
- No
- I don't know
When were you served with papers?
MM slash DD slash YYYY
What are the papers called (title of the documents)?
What Minnesota County is your case in? (The county where your case is filed or will be filed)*
- Hennepin
- Ramsey
- Anoka
- Carver
- Chisago
- Dakota
- Isanti
- Pine
- Scott
- Sherburne
- Washington
- Wright
Is there a court hearing scheduled in your case?*
- Yes
- No
- I don't know
What is the date of the hearing?*
Hidden
What Minnesota county is your case in?
Briefly describe your legal issue.*
Information for Sliding Fee Determination
Number of Adults (18 or over) residing in your household.
Number of Children (under 18) residing in your household.
Your Gross Monthly Income
Please enter a number greater than or equal to 0.
Amount You Receive Each Month From Social Security
Amount You Receive Each Month from Child Support
Amount You Receive Each Month from Spousal Maintenance
Gross Income of Any Other Adults Residing With You
Comments
This field is for validation purposes and should be left unchanged.

NOTES FOR GRAVITY FORMS: After intake form submission: Thank you for completing your online intake with Cooper Law.

If you are seeking help with Social Security Disability, our staff will contact you within 2 business days.

If you are seeking assistance with a family law matter, please click here to schedule your free 15-minute phone consultation. → directs to Calendly page

https://calendly.com/cooperlawmn/15-minute-phone-conference

Add to Gravity Forms when we make changes (Rachel or Emily): *I understand that submitting an intake form with Cooper Law, LLC does not establish an attorney-client relationship. An attorney-client relationship is not established until consultation is completed and a contract is signed by both parties.

Cooper Law, LLC
Affordable family law and social security disability representation for any income level

Streamlined processes and technology to save our clients time and money.

When it comes to legal work, time is money. Cooper Law is constantly innovating to handle legal matters more efficiently, so that you get the most bang for your buck.

Communicate Via Text

Video & Phone Conferencing Options

Paperless and Secure Cloud-Based Storage

E-Filing

Call for a phone intake

Online Intake Form

testimonials

What People SayAbout Us

The sliding fee scale was very appreciated – without that I would not have been able to go to court at all.

David

Family Law Client

Emily and her team SAVED me and my family from financial ruin with their sliding scale prices. She was able to work quickly with my case and we got everything we asked for (and more) when we went to court. She was very prepared, understood my situation well, thus predicting the next steps every time.

Alissa

Family Law Client

Very pleased with both the communication and quality of service that I got. Nothing was sugar-coated, and it turned out well for me.

Russell

Social Security Client

Outstanding. Very professional representation at a very reasonable price. They made me feel like I was their only client.

Dominic

Family Law Client

Emily not only provided me with excellent legal representation from start to finish; she also was instrumental with helping me find my voice and confidence following a difficult divorce.

Cathy

Family Law Client

Cooper Law made it possible for me to have time with my son that other attorneys said wasn’t possible. I wish I would have hired the firm from the beginning.

Derek

Family Law Client

Working with Cooper Law was great. They did everything right and everything they should have.

Ellie

Social Security Client

At Cooper Law, we believe everyone deserves access to quality legal help, regardless of economic status.

contact info

Cooper Law, LLC
Medical Arts Building
825 Nicollet Mall, Suite 925
Minneapolis, MN 55402

(612) 568-4529

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Intake Form

Lets get started

Cooper Law Online Intake Form

Information for Sliding Fee Determination

Streamlined processes and technology to save our clients time and money.

Communicate Via Text

Video & Phone Conferencing Options

Paperless and Secure Cloud-Based Storage​

E-Filing

testimonials

contact info

Quick Links

newsletter

Paperless and Secure Cloud-Based Storage