The Women's Bar Foundation's Elder Law Project connects low-income elders seeking end-of-life documents with pro bono legal representation. Our pro bono volunteers assist clients with wills, health care proxies, HIPAA authorizations, and durable powers of attorney.

The following questions will help us determine your eligibility for our services. All answers are completely confidential and will NOT be shared with anyone besides WBF staff and your attorney. 

Once you have submitted this form, you can expect to hear from us within two weeks regarding your eligibility. If we determine that you qualify for our services, we will schedule a phone evaluation.

Thank you for your interest in the Elder Law Project.

Gender
Caller on Behalf of Client?
Please provide your contact information and your relationship to the client below.
Your Contact Information
Caller Relationship to Client
Client Contact Information
CLIENT BIOGRAPHICAL INFORMATION
Gender
Race
Marital Status
English Speaking?
CLIENT FINANCIAL INFORMATION