Thank you for beginning the process of protecting your adult child's finances and health as they move into the next phase of their life. With the Grown & Flown Package your child will receive a HIPAA, Property Power of Attorney, Healthcare Power of Attorney, Advanced Directive and Nomination of Guardian and Conservator.

If you are a parent or guardian completing the intake form on behalf of your adult child, please know that your adult child is our client and will receive confirmation of the submission of this form. The information you provide below will be used to prepare the documents, so please be sure to have a conversation with your adult child regarding their options.

Next Steps:

1)Complete the below intake questions. The information you provide will be used to prepare the documents, so please be sure your elections and spellings are accurate. Also note if you are filling this form out as a Parent or Guardian, the first contact information being requested is the Client, or Adult Child.

2)Make a Payment online for $650 by clicking HERE

3)Once the above two tasks are complete, we will contact you to schedule a review and signing appointment. This could take up to 2 business days. Thank you for your patience.

If you have any questions, please feel free to contact us at our Oregon office at 503-641-6262 or our Vancouver office at 360-360-0212.

Contact information: Client Information (Adult Child)

Prefix

First name *

Middle name

Last name *

Date of birth

Company

Emails

Address *

Type

Upon submission, a copy of this form will be sent to the primary email.

Add email

Addresses

Street address

Country

City

State/Region

Zip/Postal code

Address type

Add address

Phone numbers

Phone number

Type

Add phone number

Parent or Guardian Name(s)

Please proved first and last name of parent or parent(s) completing this intake

Parent(s) or Guardian(s) Contact Information

Please provide the phone number and email address that you would like us to use to contact you

Who would the Client (Adult Child) nominate as their representative for the HIPAA Authorization, Healthcare Power of Attorney, Property Power of Attorney and Guardian/Conservator?

Click here to enter First, Middle, Last Name of Representative elections

Where is the Client (Adult Child) attending school, if applicable?

What state does the Client (Adult Child) live in, if not attending school?

Additional Comments:

Please provide us with any additional information you feel important in preparing the Grown & Flown Package for your adult child.

Disclaimer (PLEASE READ)

If a parent, or other third party, is paying for the Client, please read and acknowledge the following:

1) I understand that even though I am paying for the legal services, I am not the Client.

2) I understand that Adult Child, whose information is detailed above, is the Client.

3) I understand that it is the Client’s decision whether or not to sign the Legal Services Agreement and the prepared legal documents.

4) I understand that it is the Client’s decision as to who they nominate as their representatives.

5) I understand that the flat fee of $650 is non-refundable, even if the Client ultimately elects not to sign the document.

I acknowledge and understand the above disclaimer.

If you select no, we will not be able to proceed. The Adult Child may contact us directly to apply for the Grown & Flown Package.

Yes

How would you like us to schedule the signing appointment?

I do not need to attend the signing appointment, please contact my adult child directly to schedule.

I would like to attend the signing appointment and request that you contact me directly to schedule.

I would like to attend the signing appointment and request that when scheduling you contact my adult child and myself to schedule.

What's Next?

To proceed we will need to receive payment for the flat fee of $650. Please select or copy and paste to your browser to pay. You may also go to our website (myattandbell.com) or call us to make a payment over the phone. Please reference the Grown & Flown Package in your payment authorization.

Oregon Clients CLICK HERE FOR PAYMENT

Washington Clients CLICK HERE FOR PAYMENT

Once the retainer is received, we will reach out to schedule the signing appointment based on your selection above. The signing will be at our office as the documents need to be notarized and witnessed. Parents, or other third parties, are welcome to attend the signing at the clients' discretion, but please note we will ask to speak with the Client alone to ensure they understand the legal documents.