Pre-Consultation Form

1Your Information

2Children

3Additional Information

Your Information
First Name *(Required)
Last Name(Required)
Marital Status(Required)
- Married
- Unmarried
Email Address(Required)
Date of Birth *
MM slash DD slash YYYY
Client Gender
Spouse/Partner Information
Spouse/Partner’s First Name
Spouse/Partner’s Last Name
Spouse’s Email Address
Spouse/Partner’s Date of Birth
MM slash DD slash YYYY
Spouse Gender
Physical Address
Physical address line 1
Physical address line 2
Physical address city
Physical State
State
Physical address zip/postal code
Is your Mailing Address the same as Physical Address?
- My Mailing Address is the same
- My Mailing Address is different. I’d like to enter that address
Mailing Address
Mailing address line 1
Mailing address line 2
Mailing address city
Mailing State
State
Mailing address zip/postal code
Phone Number 1
Phone Number 1 Description
Phone 1 number
Add A Second Number
- Add Another Phone Number
Phone Number 2
Phone Number 2 Description
Phone 2 number
Add A Third Number
- Add Another Phone Number
Phone Number 3
Phone Number 3 Description
Phone 3 number

How many children do you have, living or deceased?
If you have more than 4 children let us know during the personal consultation.
Child 1
Child 1 First Name
Child 1 Last Name
Child 1 Date of Birth
MM slash DD slash YYYY
Child 1 Gender
Child 1 Email
Child 1 Phone
Child 1's Parent(s)
Child 1 Married?
- Yes
- No
Child 1's Children
Child 2
Child 2 First Name
Child 2 Last Name
Child 2 Date of Birth
MM slash DD slash YYYY
Child 2 Gender
Child 2 Email
Child 2 Phone
Child 2's Parent(s)
Child 2 Married?
- Yes
- No
Child 2's Children
Child 3
Child 3 First Name
Child 3 Last Name
Child 3 Date of Birth
MM slash DD slash YYYY
Child 3 Gender
Child 3 Email
Child 3 Phone
Child 3's Parent(s)
Child 3 Married?
- Yes
- No
Child 3's Children
Child 4
Child 4 First Name
Child 4 Last Name
Child 4 Date of Birth
MM slash DD slash YYYY
Child 4 Gender
Child 4 Email
Child 4 Phone
Child 4's Parent(s)
Child 4 Married?
- Yes
- No
Child 4's Children
Additional Children Information
Enter Additional Children Information

My estate has the following assets:
- Business/Partnerships
- Certificates of Deposit
- IRA/Retirement Plans
- Life Insurance
- Real Estate
- Stocks, Bonds, Mutual Funds
- Other
Please check one of the following boxes:
- I am ready to proceed with the creation of my plan.
- My loved one is already in a nursing home, I am ready to proceed with a plan.
- I am not interested in creating a plan at this time. I’m here for general information only.
- I need the following questions answered before I am ready to proceed with the creation of my plan:
Enter Additional Questions
Approximate gross value of my estate
I have concerns about a Special Needs family member:
- Yes
- No
What Really Matters to Me
Please rate the following estate planning goals and concerns on a scale of 1 to 10. (1 being “not important at all” and 10 being “very important.”)
Please rate the following estate planning goals and concerns on a scale of 1 to 10. (1 being “not important at all” and 10 being “very important.”)
Make sure there’s a written plan to handle my affairs
Please enter a number from 1 to 10.
Make sure Nursing Home costs don’t use up all my assets
Please enter a number from 1 to 10.
Make sure my wishes are honored regarding life support decisions
Please enter a number from 1 to 10.
I want to minimize all Death Taxes
Please enter a number from 1 to 10.
After my death, make sure my estate stays with my children if they get divorced
Please enter a number from 1 to 10.
Protect my life insurance from Death Taxes
Please enter a number from 1 to 10.
Protect my estate if my spouse gets remarried after my death
Please enter a number from 1 to 10.
After my death, protect my estate from my children’s creditors
Please enter a number from 1 to 10.
Protecting my special needs child after my death
Please enter a number from 1 to 10.
Funeral planning for my final arrangements and to make it easier for my family
Please enter a number from 1 to 10.
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At our firm, our philosophy about working with clients is that we always provide personalized service from beginning to end. When you become a client of Amato Estate Planning, our goal is to provide a collaborative approach with your trusted advisors and provide the most effective solutions for your most complex matters.

Contact Info

Amato Law, PLLC.

667 Madison Avenue, 5th Floor

New York, NY 10065

Phone: 212-355-5255
Fax: 212-937-3379

Mon-Fri : 9:00am – 5:00pm

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Your Information

Spouse/Partner Information

Physical Address

Mailing Address

Phone Number 1

Phone Number 2

Phone Number 3

Child 1

Child 2

Child 3

Child 4

Additional Children Information

What Really Matters to Me

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Contact Info

Our Location

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