Law Office of Linda Sommers Green, LLC
200 Union Boulevard, Suite 316, Lakewood, Colorado 80228
(303) 984-9900 · Facsimile (866) 399-3560 · www.coloradoestateplanning.net
LEGACY PLANNING DESIGN WORKSHEET
Please provide information that is as complete and accurate as possible. If you are unsure about
exact information, please tell me and give me the best possible assessment. When more exact
information is required, you will need to be more precise. Some of these questions may require
additional room, so please feel free to elaborate on any question either on the back side of this
checklist or on separate paper.
We realize that the questionnaire may seem fairly intrusive. Keep in mind, however, that the
more complete the information, the better it will equip both you and me throughout the planning
process. Your information will be kept confidential by my office unless you authorize or request
its release to others.
THIS FORM IS FOR INFORMATIONAL PURPOSES ONLY – IT DOES NOT
PURPORT TO GIVE LEGAL ADVICE – ITS SOLE PURPOSE IF FOR USE AT THE
LAW OFFICE OF LINDA SOMMERS GREEN
Today’s Date: __________________
Who can we thank for referring you to this office?
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Full Name:
Nickname(s):
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Occupation: ________________________________
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Prefer to be called: Home Office
Prefer correspondence sent: Home Office Military Service Record: _______________
Date of Birth: _________________ Place of Birth: ______________________________
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Name of Primary Care Provider:________________ Phone Number:______________________
Address:__________________________________________________________