Immigration Consultation Form 

Please Complete the information below completely and accurately.  

If you are unsure of an answer, please do not guess and respond with Not Sure.  

After you have submitted the form, one of our experienced immigration attorneys will contact you shortly. 

Consultation Request Type

Select one of our affordable consultation services, we offer:

  • $35 email consultation (receive a detailed response to your question within 3 business days); 
  • $50 phone consultation - 20 minute consultation regarding your immigration question.
  • $75 in office consultation - 45 minute in office in person consultation.
  • Request a Quote if you already know the service you need.

First Name
Last Name
E-Mail
Phone
Address
City
State
Zip
Alien Registration Number (A#, If any)
USCIS Receipt #(if any)
Nationality
Time in U.S.
Place of birth
Date of Birth MM DD YYYY
Current U.S. Immigration Status (check one): Citizen Resident
Visa
Visa type (if applicable)
Describe the immigration service(s) you are requesting. Please be as specific as possible.
 
 
Family Members who are Residents or Citizens of the United States:
NAME RELATIONSHIP TO POTENTIAL CLIENT AGE IMMIGRATION STATUS
 
List all entries into and exits from the United States and the manner in which you entered & exited:
DATE OF ENTRY MANNER OF ENTRENCE/ VISA TYPE DATE OF EXIT & MANNER OF EXIT
 
Name of spouse
Date of wedding?
Immigration status of spouse
Immigration status of fiancé(e)
Date(s) of prior divorce(s) MM DD YYYY
MM DD YYYY
MM DD YYYY
 
Has anyone ever applied for immigration benefits on your behalf? If so, what application(s) was / were filed and when?
 
Arrests, charges of violating any U.S. law, unsatisfied legal obligations in the U.S. (if yes, please specify what happened and when)?
 
Fingerprints taken at the border?
 
Deportation or contact with immigration officer (if yes, please specify what happened and when)?
 
Fear of returning to home country (please give details)?
 
Fear of returning to home country (please give details)?
 
Victim of abuse or crime (please give details, including time of incident(s))?
 
Are you known by any other names? Include maiden name. Yes No
If yes, list other names you have used:

Do you have a job or offer from a U.S. employer? Yes No
 
If yes, please provide the employer's name and address, and a description of the job you have been offered.
 
Please set out the reason(s) you wish to enter, or remain in, the U.S.
 
If you are applying for a visa to enter the U.S., do you wish to bring members of your family with you? Yes No
Have you ever entered the U.S. on a visa other than a tourist visa? Yes No
 
If yes, please provide the dates you were in the U.S., and the type of visa used.
 
Have you ever been denied permission to enter the U.S., or ordered to leave the U.S.? Yes No
 
If yes, please give the reason and the relevant dates.
 
Have you ever been convicted of a crime (other than non-criminal traffic offense)? Yes No
 
If yes, please provide the details, including the offense for which you were convicted, the sentence or penalty imposed, and the date of the offense.
 
If you are now in the U.S., have you been ordered to leave, or do you believe you may be ordered to leave? Yes No
 
If yes, please provide the details, including the reason for the order.
 
Have other attorneys worked on this matter? Yes No
 
If yes, provide names, addresses, and a brief description of their involvement:

 

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Madison Group LLP serves clients throughout the Chicago, Illinois, area including the cities of Oak Park, Naperville, Orland Park, Park Ridge, Berwyn, Oak Lawn, Bridgeport, Schaumburg, Cicero, Evanston, Bolingbrook, Barrington, Aurora, Skokie, and Wilmette.

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