Harford County Bar Foundation

18 S. Main Street, Suite 201
Bel Air, MD 21014
(410) 836-0123

Online InTake

Please complete the form below with your personal and legal details. Before submitting, be sure to verify that your phone number and email address are correct.

After you hit the submit button, a Harford County Bar Foundation representative will contact you to complete the screening process to determine if you are eligible for services.

For all other legal matters, please contact the office at (410) 836-0123.

Step 1 Personal Information

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Note: Please use your most reliable / most used email address.

Step 2 Legal Matter

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Please read the agreement below, confirm that you have read and understand the agreement and enter your name to electronically sign the agreement.

Agreement To Provide Limited Legal Advice

This is an agreement between you, the Harford County Bar Foundation (HCBF), and the attorney assisting you. Please read each statement carefully.

1. Consultations: I understand and agree that, if I am provided with legal advice from an attorney through HCBF, this consultation does not mean that the attorney will represent me in my case. HCBF may only be able to provide a legal consultation.

If my case requires additional legal assistance, HCBF staff will work with me to determine whether I am eligible for free legal representation through HCBF or whether I need to hire a private attorney or seek other appropriate assistance.

2. Representation: I understand and agree that HCBF cannot guarantee that an attorney will represent me in my case, nor can HCBF guarantee the outcome of my case. I understand that if an attorney does not accept my case, I will be responsible for representing myself or finding my own legal counsel.

I understand that, if I am provided with an attorney through HCBF, the attorney is only representing me in the specific legal matter in which I have requested services. The attorney is not representing me in any other legal matters that I have pending or may have in the future.

3. Honesty: I do solemnly swear and affirm that the financial information and any other information I have provided to HCBF and to my attorney are complete, true, and correct to the best of my knowledge and belief. If my financial situation changes or improves during the time that I am represented through HCBF, I agree to notify HCBF and my attorney immediately.

I understand that obtaining legal assistance by fraud, false statement, misrepresentation, failure to disclose, or impersonation is considered a crime in Maryland. (MD Code, Human Services § 11-701)

4. Household Size and Income: HCBF is an income-based organization. To receive this consultation and any other HCBF service, I agree to share my household size and income truthfully. HCBF reserves the right to request income verification information for any service. By signing below, I acknowledge that I have provided my household size and income accurately and truthfully.

5. Confidentiality: I understand and agree that the issues and information I discuss with HCBF and the attorney are considered confidential, except that HCBF staff and the attorney may discuss my case with each other, as well as resource partners that can provide additional help and assistance.

6. Conflict of Interest: I understand that a conflict of interest could arise if HCBF or the attorney has spoken with or advised another party involved with my case.

If HCBF or the attorney becomes aware that there is an unavoidable conflict of interest, I will be informed of the conflict, and in some circumstances, may not be able to receive legal consultation or representation in my case.I understand and agree that HCBF may have provided assistance in the past or may provide assistance in the future to parties with interests opposing my own.

7. Respect and Cooperation: I understand and agree that I will be respectful to and cooperate with HCBF staff, attorney(s), court personnel, as well as with the opposing party and their attorney(s).

I understand that if I am disrespectful or uncooperative, HCBF reserves the right to withdraw my application for services and/or terminate the legal consultation or representation provided by the attorney immediately.

If completed over the phone, I hereby authorize HCBF staff to sign this affidavit electronically on my behalf.

I acknowledge that I am submitting information for intake and that additional documents and information will be required to complete my application for services.

I hereby confirm with my electronic signature my acceptance of the agreement.


Type your name to acknowledge the agreement.
4/3/2026 2:07:51 AM