Get Help — Client Intake

Complete the short form below to start your intake. A member of the Medical-Legal Partnership team will review your information and reach out.

Your information is confidential. It is submitted securely to our case management system and used only by the MLP team to contact you about your request.

Before You Begin

Before completing the MLP intake form, you must review and agree to the Informed Consent and Authorization for Release of Information.

I confirm that I have accessed and reviewed the Informed Consent and Authorization for Release of Information and agree to its terms.

Please click "Review Consent Form" above to enable this acknowledgment.

This form is hosted by MyCase on behalf of the Appalachian School of Law. Submissions go directly to the MLP intake team. This site does not provide legal or medical advice. In an emergency, call 911.