LegalGEN - Questionnaire

Registration Info

Get started, provide your information below and provide your Child's info on the next page

First Name *

Middle Name

Last Name *

Email *

Password *

Cell *

Young Adult Info

Are you a parent filling this out for your college student? *

✓

Yes

✓

No

Student Name

Your Contact Details

Name:

Date Of Birth *

Also known as(optional)

Are you married? *

✓

Yes

✓

No

Suffix(optional)

✓

Jr

✓

Sr

✓

II

✓

III

✓

Other

What are your personal pronouns?

✓

he/him

✓

she/her

✓

they/them

Your Address

Full Address: *

Address Line 1 *

Address Line 2

City *

State *

County *

Zip Code *

Is Your mailing address the same as your home address? *

✓

Yes

✓

No

Your Spouse Information

Your spouse's Details

First Name: *

Middle Name *

Last Name: *

Email *

Date Of Birth *

Cell *

Suffix(optional) *

✓

Jr

✓

Sr

✓

II

✓

III

✓

Other

Also known as(optional)

What are your spouse's pronouns?

✓

he/him

✓

she/her

✓

they/them

Is Your spouse's address different than you? *

✓

Yes

✓

No

State: *

Financial DPOA:

Provide the information of one or more individuals who will serve as your agent under the Durable Power of Attorney:

Primary Agent: *

Phone Number *

Address *

Health Care POA

Please provide the information of one or more individuals who will serve as your health care agent:

Do you wish to use the same agents as your Financial Durable POA? *

✓

Yes

✓

No

Primary Agent: *

Phone Number *

Address *

Health Care POA - Spouse/Partner

Please provide the information of one or more individuals who will serve as your health care agent:

Do you wish to use the same agents as your Power of Attorney? *

✓

Yes

✓

No

Primary Agent: *

Phone Number *

Address *

Summary

If you would like to review your responses, please review your responses on the right hand side on the specific screens. After you click submit, you will be finished and we will email your answer and the office will contact you with the next steps .

Preview Answer

Your Progress