Welcome to Loose Law Group

Please complete the following form to get started.

Step 1 of 3

Your Contact Information

First Name*

Last Name*

Last 4 of SSN*

Date of Birth*

Hidden

Last 4 of SSN*

Email Address*

Employer

Address*

City*

State*

Zip*

Cell Phone*

Home Phone

Work Phone

Preferred Method of Contact

Do you have a spouse or domestic partner?

Are you legally married?

Your Spouse or Partner

First Name

Last Name

Last 4 of SSN

Date of Birth

Email Address

Employer

Cell Phone

Home Phone

Work Phone

Your Request

Are you on a Legal Plan?

Yes

Legal Plan

Membership Number

Case Number

How did you hear about our firm?

Please clarify

Please describe the nature of your legal matter

(limit 200 characters)

Yes, I understand submitting this form does not create an attorney-client relationship. By submitting, I am consenting to Loose Law Group, P.C. contacting me.

Welcome to Loose Law Group

Your Contact Information

Your Spouse or Partner

Your Request

Scottsdale

Tucson

Paradise Valley

Phoenix

Practice Areas