CAP Request Form

"*" indicates required fields

First Name

Last Name

Street Address*

City*

State*

Zip Code*

Daytime Phone Number*

Email*

Name of the Attorney or LPP About Whom you Have a Problem*

The Attorney or LPPs Firm Name and Address:*

Does the attorney represent you?*

Yes

If No, please explain.*

Have you talked with the lawyer named about the subject of this request?*

Yes

Tell us the problem you are having . Please give a detailed statement of facts, including dates and places, explaining why you are requesting assistance with regard to this lawyer:*

Please explain the assistance you are requesting of the Consumer Assistance Program.*

Type your name for signature purposes*

“I understand that by requesting assistance, the attorney in question and the Consumer Assistance lawyer may disclose and share with each other confidential and privileged information. I authorize release of all claims I may have against my attorney and the Consumer Assistance lawyer relating to disclosure.”

“I understand it may be necessary to act promptly to protect my rights, and commencement of a civil action may be required to preserve my rights. I understand that completing this form does not constitute commencement of a civil action, such as a malpractice action, and that the Utah State Bar will not commence any such action. I acknowledge it is my responsibility to seek and obtain any necessary legal advice with respect to this matter.”

CAPTCHA

CAP Request Form

"*" indicates required fields

First Name

Last Name

Street Address*

City*

State*

Zip Code*

Daytime Phone Number*

Email*

Name of the Attorney or LPP About Whom you Have a Problem*

The Attorney or LPPs Firm Name and Address:*

Does the attorney represent you?*

Yes

If No, please explain.*

Have you talked with the lawyer named about the subject of this request?*

Yes

Tell us the problem you are having . Please give a detailed statement of facts, including dates and places, explaining why you are requesting assistance with regard to this lawyer:*

Please explain the assistance you are requesting of the Consumer Assistance Program.*

Type your name for signature purposes*

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CAP Request Form

CAP Request Form

CAP Request Form

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