About this template
A Bankruptcy Intake Form is essential for law firms, credit counseling agencies, and debt advisors seeking to gather comprehensive financial details from clients before an initial consultation. This form streamlines the client onboarding process by capturing crucial information such as employment status, monthly income and living expenses, total debt amounts, asset inventories, and creditor lists.
By collecting these details in advance, legal professionals can accurately evaluate a client's financial standing, determine eligibility for Chapter 7 or Chapter 13 bankruptcy, and formulate an effective debt relief strategy. Doc2Form allows legal practices to instantly convert documents or build out structured Google Forms for secure, organized data collection without the administrative bottleneck of manual paperwork.
Key features
- Capture complete financial profiles, income, and monthly expenses in one step.
- Itemize debts, medical bills, student loans, and major asset categories.
- Collect spouse and employment details for joint filing assessments.
- Streamline client intake and reduce initial consultation prep time.
- Organize all responses directly in Google Sheets for instant review.
Use cases
Law firms conducting pre-consultation financial reviews for prospecti…
Law firms conducting pre-consultation financial reviews for prospective bankruptcy clients.
Credit counseling agencies gathering baseline data for debt managemen…
Credit counseling agencies gathering baseline data for debt management plans.
Debt settlement advisors assessing total liabilities and asset distri…
Debt settlement advisors assessing total liabilities and asset distribution.
What this form collects
- Full Name (Short answer)Enter your first, middle, and last name.
- Email Address (Short answer)Enter the best email address for appointment confirmations and document sharing.
- Phone Number (Short answer)Enter your primary contact number.
- Current Residential Address (Paragraph)Include street address, city, state, and ZIP code.
- Marital Status (Multiple choice)Select your current marital status.
- Spouse's Full Name (Short answer)If applicable, enter your spouse's full legal name.
- Spouse's Email Address (Short answer)If filing jointly, enter your spouse's email.
- Spouse's Phone Number (Short answer)If filing jointly, enter your spouse's phone number.
- Employer Name (Short answer)Enter your current employer or company name.
- Occupation / Job Title (Short answer)Enter your current role or title.
- Employment Start Date (Date)Approximate date when you started your current job.
- Gross Monthly Income (Short answer)Enter your total monthly household income before taxes.
- Monthly Living Expenses (Paragraph)Estimate your average monthly expenses for rent/mortgage, utilities, food, and transportation.
- Total Estimated Debt Amount (Short answer)Provide a rough total of all unsecured and secured debts combined.
- Total Medical Debt (Short answer)Enter the approximate amount owed to hospitals, doctors, or medical providers.
- Total Student Loans (Short answer)Enter the approximate balance of federal or private student loans.
- List of Major Assets (Paragraph)Describe any real estate, vehicles, bank accounts, or valuable personal property you own.
- List of Creditors (Paragraph)List the main companies or individuals you currently owe money to.
- Intended Bankruptcy Type (Multiple choice)Select the type of bankruptcy you are inquiring about, if known.
- Preferred Consultation Date & Time (Paragraph)Please paste a link to your calendar preferences or note your availability for a meeting.
FAQ
What is a bankruptcy intake form used for?
It is used by attorneys and financial advisors to collect a client's income, expense, asset, and debt details before an initial consultation to determine the best debt relief options.
Can I customize the questions in this Google Form template?
Yes, once the template is in your Google Drive, you can fully edit, add, or remove any questions to fit your firm's specific intake requirements.
Is this form template free to use?
Yes, this template is completely free to copy and use via Doc2Form and Google Forms.
How do I share this form with clients?
You can send clients a direct link via email, embed the form on your secure website, or QR code it for office intake kiosks.
Where are client responses stored?
All submissions are securely saved in your connected Google Sheet, allowing your legal team to review data instantly.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.