What is the bankruptcy client intake form template?
A bankruptcy consultation goes much better when the attorney has seen the numbers first. Without them, the first half hour is spent asking what the client earns, whether they own their home, and who's calling them — and the client often forgets the debt that turns out to matter most.
This template walks the client through six short pages. It starts with the household and where they've lived, moves to income and monthly costs, then to the home, vehicles and savings. Owning a home opens the questions an attorney needs right away: value, mortgage balance, any second mortgage, whether payments are behind, and whether a foreclosure sale date has been set.
The debts page asks for every creditor in one place, with balances and whether each debt is in collection or being sued on. The last pages cover recent transfers, repayments to family, lawsuits, earlier filings and how urgent things are. Every questionnaire is saved as a PDF in your FileIt vault, with any statements the client uploads attached.
- Best for
- Bankruptcy and consumer debt attorneys, legal clinics and debt advice services
- Filled in by
- The prospective client, before the first consultation
- Time to complete
- About 20 minutes, longer with statements to hand
- Includes
- Household, income, home and equity, assets, debts by creditor, transfers, lawsuits, prior filings, urgency
Who uses a bankruptcy client intake form?
- A "get started" link on a bankruptcy firm's website
- Sending to a caller after a short phone screen, so the consultation can start with the facts
- Legal aid clinics preparing volunteer attorneys before a debt clinic session
- Spotting urgent cases — a foreclosure sale or garnishment — the day they come in
- Clients who want to think through their situation privately before talking to anyone
- Keeping a dated record of what the client told you at intake
Questions on this bankruptcy client intake form
53 questions over 6 pages · includes file upload, conditional questions, multiple pages, consent checkbox.
1 You & your household
- Your full name*
- Email*
- Phone*
- Home address*
- Have you lived in your current state for at least the last two years?*
- Where else have you lived in the last two years? asked only when it applies
- Marital status* Married · Single · Separated · Divorced · Widowed
- Is your spouse also looking for help with debts? asked only when it applies Yes, we'd like to discuss filing together · No, just me · Not sure yet
- How many people live in your household, including you?*
- Dependents you support
2 Income & expenses
- Your work situation* Employed · Self-employed or own a business · Not working · Retired · Unable to work due to disability
- Employer's name asked only when it applies
- What does your business do? asked only when it applies
- Your take-home pay per month*
- Spouse's take-home pay per month asked only when it applies
- Other income your household receives Social Security or disability benefits · Child support or alimony · Pension or retirement income · Rental income · Unemployment benefits · Regular help from family · None
- Total household income over the last six months, before tax
- Usual monthly living costs*
- Are your tax returns up to date? Yes, all filed · No, some years aren't filed · Not sure
3 Home & property
- Do you own your home?*
- Estimated home value asked only when it applies
- Mortgage balance owed asked only when it applies
- Is there a second mortgage or home equity loan? asked only when it applies
- Second mortgage or home equity balance asked only when it applies
- Are you behind on mortgage payments? asked only when it applies
- How many payments behind? asked only when it applies
- Foreclosure sale date, if one has been set asked only when it applies
- Would you like to keep the home? asked only when it applies Yes, keeping it is important to me · No, I'm ready to let it go · I'm not sure
- Vehicles you own or lease
- Cash and money in bank accounts today (total)
- Do you have a 401(k), IRA or pension?
- Other things of value
4 Debts
- Which kinds of debt do you have?* Credit cards · Medical bills · Personal or payday loans · Car loan · Student loans · Tax debt · Child support or alimony arrears · Business debts · Court judgments
- Debts by creditor*
- Approximate total owed, not counting your mortgage or car loan
- Has anyone co-signed or guaranteed any of these debts?
- Who co-signed, and for which debt? asked only when it applies
- Are your wages or bank account being garnished?
- Which creditor, and how much is being taken? asked only when it applies
- Statements, collection letters or a credit report (optional)
5 Recent history
- In the last two years, have you sold, given away or transferred any property, vehicle or sizable sum of money, including to family or friends?*
- What was transferred, to whom, when, and what you received for it* asked only when it applies
- In the last year, have you paid back money you owed to a relative or friend?*
- Who, roughly when and how much asked only when it applies
- Are you involved in a lawsuit or court case on either side, or has anyone threatened to sue you?*
- Which court, the case number if you know it, and what it's about* asked only when it applies
- Have you filed for bankruptcy before?*
- When, where and which chapter asked only when it applies
- Have you completed a credit counseling course in the last six months?
6 What you need
- What matters most to you right now?* Stopping a foreclosure · Stopping a wage or bank garnishment · Ending collection calls · Dealing with a lawsuit · Keeping my car · A fresh start
- How soon do you need to talk to someone?* Urgently — a sale, garnishment or court date is less than two weeks away · Within the next few weeks · I'm exploring my options
- Anything else your attorney should know
- Consent*
The bankruptcy client intake form, page by page
1 You & your household
Name, email, phone and home address. "Have you lived in your current state for at least the last two years?" — a no asks where else they've lived. Marital status (married asks whether the spouse is also looking for help), household size and the dependents they support.
2 Income & expenses
Their work situation, with the employer's name or what their business does. Take-home pay per month, the spouse's take-home pay when married, other household income such as benefits, support or rental income, total income for the last six months before tax, usual monthly living costs, and whether tax returns are up to date.
3 Home & property
"Do you own your home?" Yes reveals the estimated value, the mortgage balance, whether there's a second mortgage or home equity loan (and its balance), whether payments are behind, how many, any foreclosure sale date, and whether they'd like to keep the home. Then vehicles, cash and bank balances, retirement accounts and other things of value.
4 Debts
A checklist of debt types, then the key question: "Debts by creditor", one per line with a rough balance and whether it's in collection or being sued on. An approximate total, any co-signers, any garnishment (and which creditor), and an optional upload for statements, collection letters or a credit report.
5 Recent history
Transfers of property, vehicles or money in the last two years, repayments to relatives or friends in the last year, lawsuits on either side, earlier bankruptcy filings and a recent credit counseling course. Every yes asks for the details.
6 What you need
What matters most — stopping a foreclosure or garnishment, ending calls, keeping a car, a fresh start — how soon they need to talk, a free-text box and a consent confirming the form doesn't create an attorney-client relationship.
Make the template yours
- Change the residency question to match the jurisdiction you practise in
- Add your consultation fee, or a note that the first meeting is free, to the cover text
- Turn the vehicles box into separate questions if you handle a lot of car loans
- Add a notification email for the paralegal who books consultations
- Send responses to a private folder that only your bankruptcy team can open
- Shorten the form for a free clinic by removing the six-month income and tax questions
Tips for a better bankruptcy client intake form
- Read the urgency answer and the foreclosure sale date first — those cases can't wait for the usual callback
- Ask clients to fill it in with recent statements or a free credit report open beside them
- Use the creditor list to run your conflict check before the meeting
- Treat the answers as a starting point; your own review of documents still matters
Every response becomes a PDF in your vault
Each questionnaire is filed as a PDF in the vault folder you choose, with uploaded statements attached, and you get an email. The client is emailed a copy of their answers, which you can switch off in the form's settings.
The Responses table lists every intake with its date, so your team can see who still needs a call back and export the list to CSV.
- Start from this template. It opens in the FileIt Forms designer — change any question, add pages, set the rules for when questions appear.
- Share it. Turn on a public link, or send it to people by email, each with their own link. They don’t need a FileIt account.
- Get the answers as PDFs. Each response is saved as a PDF in the vault folder you choose, with uploaded files attached — and listed in a Responses table you can export to CSV.
Bankruptcy client intake form: frequently asked questions
Is this bankruptcy intake template free?
Yes. It's one of the ready-made templates in FileIt's Forms app, which comes with every plan, including the free one.
Does the client need a FileIt account?
No. Anyone with the link can open the form and submit it. Only you, as the form owner, need an account.
Will this tell someone whether they qualify for bankruptcy?
No. It gathers information for an attorney to review. It doesn't calculate eligibility or recommend a chapter, and it isn't legal advice.
Why does it ask about transfers and repayments to family?
Attorneys usually want to know about these before a case is filed. Asking at intake means they come up early instead of being discovered later.
Can clients save the form and come back to it?
It's built to be finished in one sitting. Gathering statements first and using estimates where needed keeps it manageable.
Can I change the questions?
Yes. Every label, option and page can be edited in the designer, and you can add or remove questions before you publish.