Client - Name(Required) First Last Client - InfusionSoft Email(Required) Date(Required) MM slash DD slash YYYY Your Name(Required)Select Your Name *AlejandraByrdieCynthiaLupitaMaferName of Person Placing the Call(Required) First Last Are they currently living in the US.?(Required) No Yes - Less than 1 year Yes - Greater than 1 year If more than 1 yr illegally – Select Family Consult from case type. If "No" or less than 1 year - Select either Employee or Employer from case typeReferral List(Required)TBDTBDTBDTBDTBDTBDU-VisaAll OtherLanguage for future communications(Required)Select Language *EnglishSpanishPhone (person attending consultation)(Required)Name of person who will attend the consultation(Required) First Name Last Name Email (person attending consultation)(Required) Address (person attending consultation)(Required) Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zip Code Relationship between person attending consult and beneficiary of the process(Required)Choose RelationshipParentSpouseBrother or SisterAunt or UncleCousinFriendOtherWhat is the main goal for this consultation?(Required)Is the beneficiary of the case in the US today ?(Required) Yes No How did they enter the US?(Required) Is there proof of the legal entry?(Required) Yes No When was the last time they entered the US?(Required) MM slash DD slash YYYY Before that entry, were they living in the US?(Required) Yes No Have they ever claimed US citizenship?(Required) Yes No When was US Citizenship claimed?(Required) MM slash DD slash YYYY Have they ever had any problems with immigration either inside US or at the port of entry?(Required) Yes No If Yes, what happened, when & what city, state?(Required)Have they ever had problems with the police anywhere?(Required) Yes No If Yes, what happened, when & what city, state?(Required)Has anyone ever petitioned Immigration for them in the past?(Required) Yes No If Yes, Who, When and Where(Required)Is your spouse or ever been in the military?(Required) Yes No Are your parents or grandparents US Citizens?(Required) Yes No Has anyone ever petitioned their parents with Immigration?(Required) Yes No Have they ever been a victim of crime in the US or helped the police to prosecute someone?(Required) Yes No Do you have a family member that is a U.S. Citizen or permanent resident? Yes No Immigration SituationAdditional DetailsLeadsource(Required)Select LeadsourceCommunity Church San AntonioCommunity ConferenceCommunity Conference GinaCommunity Conference LevinCommunity Flea MarketCommunity OtherI Didn't AskInternet-NewsletterAre they ready to schedule the appointment?(Required) Yes No AttorneySelect AttorneyAlfredo LozanoViviana Molina Appointment LocationSelect LocationMain OfficeSan Angelo OfficeLaredo LocationMidland LocationEagle Pass LocationBy SkypeBy PhoneOtherAppointment Date(Required) MM slash DD slash YYYY Send Emails? Yes No Send Text?(Required) Yes No Outcome Appointment Set No Appointment Set EmailThis field is for validation purposes and should be left unchanged.