Lawyer Referral Service Panelist Sign Up

Lawyer Referral Service Panelist Sign Up

Click here for a downloadable application that can be faxed or mailed to the Indianapolis Bar Association.

Want to maximize your LRS experience? Consider taking advantage of the Legal Advice Hotline at no additional fee. Details can be found within the LRS Regulations and Rules of Operation.

$ 250.00
$ 0.00
Contact Details
  1. Mr. Mrs. Ms.
Degree Information
  1. Enter law school name

Professional Information
  1. Yes   No

  2. Yes   I have applied for membership   No

    required for participation

Required Documents
  1. Attach a copy of your professional liability insurance declaration page (.pdf format only)

  2. Attach a copy of your W9 (.pdf format only)

County Information

My principal office zip code is marked with a "1". I understand that I may select additional referral areas, and must be willing to travel to those location. Additional areas are marked with an "X".

Case Type Information

Of the major categories listed below, select a maximum of five to describe the types of cases for which you will accept referrals. Within the categories, please check all the types of cases you wish referred (LRS=Lawyer Referral Service, LAH=Legal Advice Hotline).

Administrative Law
  1. LRS LAH Both
  2. LRS LAH Both
  3. LRS LAH Both
  4. LRS LAH Both
  5. LRS LAH Both
  6. LRS LAH Both
  7. LRS LAH Both
  8. LRS LAH Both
  9. LRS LAH Both
  10. LRS LAH Both
  11. LRS LAH Both
  12. LRS LAH Both
Business Law
  1. LRS LAH Both
  2. LRS LAH Both
  3. LRS LAH Both
  4. LRS LAH Both
  5. LRS LAH Both
Criminal Law
  1. LRS LAH Both
  2. LRS LAH Both
  3. LRS LAH Both
  4. LRS LAH Both
  5. LRS LAH Both
  6. LRS LAH Both
  7. LRS LAH Both
  8. LRS LAH Both
  9. LRS LAH Both
  10. LRS LAH Both
Civil Rights
  1. LRS LAH Both
  2. LRS LAH Both
  3. LRS LAH Both
  4. LRS LAH Both
Debtor / Creditor
  1. LRS LAH Both
  2. LRS LAH Both
  3. LRS LAH Both
  4. LRS LAH Both
  5. LRS LAH Both
  6. LRS LAH Both
  7. LRS LAH Both
  8. LRS LAH Both
Domestic & Family Law
  1. LRS LAH Both
  2. LRS LAH Both
  3. LRS LAH Both
  4. LRS LAH Both
  5. LRS LAH Both
  6. LRS LAH Both
  7. LRS LAH Both
Intellectual
  1. LRS LAH Both
  2. LRS LAH Both
  3. LRS LAH Both
  4. LRS LAH Both
Liability / Negligence
  1. LRS LAH Both
  2. LRS LAH Both
  3. LRS LAH Both
  4. LRS LAH Both
  5. LRS LAH Both
  6. LRS LAH Both
  7. LRS LAH Both
  8. LRS LAH Both
  9. LRS LAH Both
  10. LRS LAH Both
  11. LRS LAH Both
Probate & Estate Planning
  1. LRS LAH Both
  2. LRS LAH Both
  3. LRS LAH Both
  4. LRS LAH Both
  5. LRS LAH Both
  6. LRS LAH Both
  7. LRS LAH Both
Real Estate
  1. LRS LAH Both
  2. LRS LAH Both
  3. LRS LAH Both
  4. LRS LAH Both
  5. LRS LAH Both
  6. LRS LAH Both
  7. LRS LAH Both
  8. LRS LAH Both
  9. LRS LAH Both
Miscellaneous
  1. LRS LAH Both
  2. LRS LAH Both
  3. LRS LAH Both
  4. LRS LAH Both
  5. LRS LAH Both

I have read this Application, Regulations and Rules of Operation and Agreement, and I am aware of its contents. I acknowledge that I have full responsibility for handling any matters which I agree to undertake as a consequence of receiving referrals through the Legal Services Program, and I therefore agree to fully indemnify and hold harmless the Indianapolis Bar Association for any and all claims, actions, damages, expenses and losses, including any malpractice claims that may be asserted against me. I represent that all statements contained herein are true, and I agree to abide by the Regulations and Rules of Operation and this Application and Agreement.

Total Price:
$ 0.00