Lawyer Referral Service Guidelines

Name:_______________________________________  Office Phone: ________________________

 

Firm: _____________________________________________________________________________

 

Address: __________________________________________________________________________

Essex County Bar Association

Lawyer Referral Service

Registration

· You agree to inform the client to contact the ECBA for another referral if you cannot take the case.  Do not allocate an ECBA referral to another attorney.   

 

· Referrals are made on a strictly rotational basis according to geography and specialty demands by the caller.  Subscribers to this service must be members of the Essex County Bar Association.

 

· The annual registration fee of $65 must be submitted with a completed registration form.

 

· Before referrals can be made, you must send a CURRENT COPY of the DECLARATION PAGE of your PROFESSIONAL LIABILITY INSURANCE.  The ECBA requires minimum coverage of $100,000 and $300,000.  REFERRALS CANNOT BE MADE WITHOUT THIS DOCUMENT.

 

· To qualify for admission to the Essex County Bar Association’s Lawyer Referral Service, you must be a member in good standing with the Massachusetts bar and the ECBA.

 

· You must remit to the ECBA 10% OF ANY FEE OVER $50.00 THAT RESULTS FROM A REFERRAL.

 

· Members must agree to a FREE 30 MINUTE INITIAL CONSULTATION.  Any fee arrangement beyond the initial consultation is between the lawyer and the client.

 

· Panel members must affirm that no formal disciplinary action has been taken against them by the Board of Bar Overseers in the past five years.  If formal disciplinary action is taken by the BBO against a panelist, it is incumbent upon the panelist to notify the ECBA.  (Disciplinary action by the BBO results in the suspension of an attorney from the ECBA LRS panel).

 

· When we refer a potential client to you, a follow-up letter or e-mail will be sent to you requesting the status of this referral (if the client called; did you retain him/her?).

 

 

       I have read the program guidelines which govern the Essex County Bar Association Lawyer Referral Service and will abide by these requirements.

 

 

       Signature ______________________________________  Date ____________________

Name:______________________________________________________________________________

Address:___________________________________________________________________________

                  ____________________________________________________________________________

Telephone: __________________________________   Fax: ________________________________

E-mail Address (print): _____________________________________________________________

Date of Admission to the Massachusetts Bar: ______________  BBO# ______________

Est. 1806

Essex County Bar Association

The Nation’s Oldest County Bar Association

2011-2012 Application for Membership

(Fiscal Year: September 1, 2011—August 31, 2012)

Please make checks payable to:   Essex County Bar Association

Shetland Office Park

45 Congress Street, Suite 4100

Salem, MA  01970

Phone: 978.741.7888  Fax: 978.741.1348

 

 

 

2011-2012 Dues Schedule

 

(Please check appropriate category)

 

_____       Regular Member (5 years and more):        $75.00

_____       New Lawyer (1 through 4 years):             $45.00

_____       Law Student (see requirements below):    $45.00

 (Must be in Law School and either work or reside in Essex County)

Exempt    By The Bar 50 Years -  (prior to and including 1961)

 

_____     Lawyer Referral Service:                           $65.00

              (Please fill out the following two pages. Include a copy of liability insurance coverage)

 

 

Area(s) of Practice:                        

[  ]  Bankruptcy & Creditors’ Rights

[  ]  Civil Litigation

[  ]  Criminal Law

[  ]  Family and Probate Law

[  ]  Employment Law

[  ]  Real Estate

[  ]  New Lawyer

FOR ECBA OFFICE USE ONLY

 

Amount Paid: ___________        Date: ___________       Check #: _________

 

Regular _____

Refer _____

Outlook _____

CSV _____

Board _____

 

 

 

 

[ ]  Administrative 

 

       [ ] DOR

       [ ] Federal Agencies

       [ ] Municipal Agencies

       [ ] State Agencies 

       [ ] Military

 

[ ] Admiralty          

 

[ ]  Bankruptcy        

 

[ ]  Business/Corporate     

 

       [ ]  Non-Profit       

       [ ]  Partnerships/Corporations                

[ ] Civil Rights/Discrimination 

[ ]  Civil Rights/Liberties  

       [ ]  Age Discrimination

       [ ]  Employment Discrimination

       [ ]  Gender Discrimination

       [ ]  Handicap Discrimination 

       [ ]  Mental Health Discrimination

       [ ]  Pregnancy Discrimination

       [ ]  Race Discrimination

       [ ]  Religion Discrimination

       [ ]  Police Brutality

       [ ]  Prisoners’ Rights         

 

[ ]  Collections       

       [ ]  Debtor

       [ ]  Creditor

          

 [ ]  Consumer Protection/93A

       [ ]  Construction                 

       [ ]  Credit Cards    

       [ ]  Investment Fraud

       [ ]  Mortgage Foreclosure/Fraud

 

[ ]  Contracts          

        [ ]  Drafting

       [ ]  Litigation         

 

[ ]  Criminal 

       [ ]  Appeals Court 

       [ ]  District Court   

       [ ]  Juvenile Court

       [ ]  Superior Court

       [ ]  DWI/Traffic Violations

 

 

 

[ ]  Probate/Estate Planning

 

       [ ]  Elder Law

       [ ]  Estate Planning

       [ ]  Guardianship

       [ ]  Trusts

       [ ]  Wills/Living Wills

 

[ ] Real Estate

 

       [ ]  Commercial

       [ ]  Condominiums

       [ ]  Eminent Domain

       [ ]  Environmental

       [ ]  Mortgage/Foreclosure

       [ ]  Residential

       [ ]  Zoning/Planning

 

[ ]  Taxation

 

[ ]  Tort/Civil Suit

 

       [ ]  Asbestos

       [ ]  Automobile Accident

       [ ]  Defamation      

       [ ]  Dental Malpractice

       [ ]  Harassment

       [ ]  Lead Paint

       [ ]  Legal Malpractice

       [ ]  Medical Malpractice

       [ ]  Personal Injury

       [ ]  Product Liability

       [ ]  Veterinary Malpractice

       [ ]  Wrongful Death

 

[ ]  Tort Defense

 

Special Qualifications

 

       [ ]  Appeals Court

       [ ]  Federal Courts

       [ ]  Mediation

       [ ]  Arbitration

 

Admitted to Bar in States:

 

 

Languages:

 

 

 

 

[ ]  Disability Income        

                              

       [ ]  Medicaid          

       [ ]  Pension

       [ ]  SSI

       [ ]  SSDI

       [ ]  SSI/SSDI OVERPAYMENT

       [ ]  Workers’ Compensation           

       [ ]  Veteran’s Administration        

  

[ ]  Education

 

       [ ]  Chapter 766     

       [ ]  Teacher/Student Rights       

 

[ ]  Employment            

 

       [ ]  ERISA

       [ ]  Management/Union     

       [ ]  Termination Rights     

       [ ]  Unemployment Comp.

       [ ]  Unemployment APPEALS

 

[ ]  Family Law                     

 

       [ ]  209A/TRO       

       [ ]  Adoption          

       [ ]  Divorce

       [ ]  DSS     

       [ ]  Grandparent Rights     

       [ ]  Paternity

       [ ]  Support/Custody

 

[ ]  Identity Theft

 

[ ]  Immigration

 

[ ] Insurance                        

 

       [ ]  Automobile      

       [ ]  Homeowners   

       [ ]  Medical/Disability           

 

[ ]  Intellectual Property

 

       [ ]  Copyright/Trademark  

       [ ]  Patent

       [ ]  Internet Law

 

 

[ ]  International Law

            

 

[ ]  Landlord/Tenant

 

 

 

 

 

 

 

REFERRAL CATEGORIES

You may select up to five (5) major categories.  Please specify which of the sub-categories you wish to receive referrals for.  For Reduced Fee Referrals: place an “R” next to desired categories.       PLEASE BE SURE TO PRINT, SIGN AND RETURN THE LRS AGREEMENT.

 

 

The ECBA requires minimum liability coverage of $100,000 and $300,000.  Please ensure that we have a copy of your current declaration page.