Covenant Life Church

2nd Saturday of each month

7501 Muncaster Mill Dr Gaithersburg, MD 20877

 

 

 

All GSA Clinics are by APPOINTMENT ONLY. 

To request an appointment please fill out the form below. 

 
 

Because we respect your privacy and the confidentiality of your legal matter, we do not accept document uploads through our website. If you have files and documents you feel are pertinent to your case, we appreciate you sending those to Ronia.Dubbaneh@gsadvocates.org

Intake Form

Many people have questions regarding the type of legal care that we can give. We counsel on family lawchild supportdomestic situationslandlord, and commercial disputes. We do not handle criminal cases.

We are a legal aid organization that serves low income families and individuals in greater Washington DC. If your income exceeds our guidelines, you might not qualify for our services. Because we have more requests for help than we can meet, we must prioritize our services for those in the most need. 

Feel free to send additional questions to edrake@gsadvocates.org.

Name of Client *
Name of Client
Gender *
Home Address *
Home Address
Phone Number *
Phone Number
Are You Employed? *
Please list all the benefits you receive (social security, general welfare, WIC, alimony, child support, medicare, disability income, worker's compensation, etc.)
We perform a conflicts check before your appointment to make sure we have not previously met with your spouse, ex-spouse, or an opposing party about your legal issue. We do this to protect your confidentiality. If your matter is a conflict with another person or organization, please name the opposing party.
Marital Status *
If you're married or divorced, what is the name of your spouse or ex spouse?
If you're married or divorced, what is the name of your spouse or ex spouse?
Do you have children? *
Do your children live with you?
Do you support them financially?
About Your Legal Issue
Do you have a pending or upcoming:
When is your proceeding, hearing, or deadline? Where is it? What is it for?
Are you currently being represented by an attorney for any of these matters? *
Please categorize your issue(s) *
Do you attend a church? *
Will you require an interpreter during your appointment? *
If you will be bringing your own interpreter, please provide his/her name.
If you will be bringing your own interpreter, please provide his/her name.
Interpreter's phone number
Interpreter's phone number