Request a Free Elder Law Consultation

Use this form to ask an Arizona attorney about long-term care, ALTCS, guardianship or other elder law questions for yourself or a family member. It takes about two minutes. It costs nothing to ask, and you are not agreeing to hire anyone.

Please read this first. We are not a law firm and we do not give legal advice. Sending this form does not make anyone your lawyer and does not create an attorney-client relationship. A lawyer represents you only after you and that lawyer agree to it. Because we are not lawyers, what you send us may not be protected by attorney-client privilege. Sending this form does not stop or pause any court or filing deadline. An attorney or law firm that receives a request may pay us, or we may send a request at no charge. Our service is always free to you. Many Arizona attorneys offer a free first consultation and some charge a fee. The attorney who contacts you will tell you their terms before you hire them.

Before you fill it in

Keep it short. A few sentences about the situation is enough, such as who needs care and what has happened so far.
Leave out sensitive numbers. Please do not type Social Security numbers, bank account numbers, Medicare numbers or full medical records. A lawyer who takes up your request can ask for documents in a safer way.
Ask before moving money or property. Medicaid long-term care (ALTCS) has a look-back period for gifts and transfers. Talk to a lawyer before you move assets, and do not wait on this form if a decision is due soon.
Check the date on any ALTCS denial letter. The time to ask for an appeal hearing is short, about 35 days from the date on the letter, and the letter states the exact deadline. Do not wait on this form to meet it.

Your details

Elder Law Consultation Request

Full name

Phone

ZIP code

What do you need help with?

Briefly describe your situation (optional)

By submitting this form, I agree that Wilder West Assets LLC may contact me by phone and email about my request, and may send the information I provide to one Arizona attorney or law firm it selects to review my possible elder law matter. I agree that the attorney or firm may contact me about my request by phone at the number I provided and by email, even if my number is on a Do Not Call list. Calls will be made by a person, not by an autodialer or a recorded message. We send each request to only one attorney or law firm. Submitting this form does not create an attorney-client relationship. See our Privacy Policy.

What happens after you send it

Your request is saved and sent to us. We do not judge your situation. We are not lawyers.
We send your details to one Arizona attorney or law firm we select to review your request, as the consent box you checked says. Each request goes to only one attorney or firm.
If a lawyer thinks they may be able to help, they may contact you by phone or email. A reply is not promised. A lawyer may decide not to take a matter for many reasons.
You decide what to do next. You are free to talk to any lawyer you choose, or to none.

What we do with your information

We keep your request, the time you sent it, the internet address it came from and the consent wording you agreed to. We send your details to a law firm only as that consent wording says. Our privacy policy explains how long we keep your information and how to ask us to delete it.

Want to read first? Start with our arizona elder law guides, or go back up to the form.