CLIENT INTAKE

Tell us about
your case.

Please complete this intake form as thoroughly and accurately as possible so we can understand your situation and determine how we may assist you. All information provided is confidential and will be used solely to evaluate your immigration matter. After submission, our team will review your information and contact you regarding next steps.

1. Personal Information (Applicant / Beneficiary / Respondent)

Name *Date of birthGenderCountry of birthCountry of citizenshipCell phone *Email *Address

2. Immigration Status and Entry

Current immigration statusMost recent entry dateTime in the US

3. Immigration ObjectivePlease explain in detail what you would like to accomplish regarding your immigration goals:

4. Immigration HistoryPlease list any previous immigration applications, petitions, or proceedings, including the type of application, approximate date, and outcome, if known:

5. FamilyDo you have immediate family members who are US citizens or Lawful Permanent Residents (green card holders)? If so, please list their name, relationship to you, and immigration status.

6. Employment

Employment / OccupationCurrent employer

7. Other relevant issues

Have you been arrested, charged with, or convicted of a crime anywhere in the world?Have you ever been denied a visa, admission to the US, or any immigration benefit?If yes to any of the above, please briefly explain:Please provide any additional information you believe may be relevant to your case or helpful for the attorney to know:

This intake form collects preliminary information for attorney preparation. It is not a legal assessment.

Become a part
of our family.

You don’t have to know every answer.
You just have to take the first step.

PHONE949.883.6002 EMAILJIL@josimmigration.com

OFFICE1918 W. Chapman Ave., Suite 201
Orange, CA 92868

WEBSITEjosimmigration.com

Monday–Friday, 7 am–5 pm
Saturday & Sunday · Closed
Phone lines are open 24/7.

Tell us aboutyour case.

Become a part of our family.

Tell us a little about yourself.

Tell us about
your case.

Become a part
of our family.