Information for the Public

Crisis Empowerment Client Form

Crisis Empowerment Client Information

Note: This information must be provided to the client to complete the modest means referral.

I certify I qualify for the Indianapolis Bar Association’s (IndyBar) Crisis Empowerment Program (CEP). I have been advised the IndyBar CEP parameters associated with hiring an attorney include:

  • My income must not exceed 250% of Federal Poverty level guidelines.

  • The referred attorney may choose to conduct their own financial analysis;

  • I will be provided by the attorney referred to me with a written fee agreement for my signature indicating that I will be provided with up to five hours of assistance at no fee to me. 

  • Should more than five hours of work be needed, the hourly rate for any additional time will be discussed and approved by me in advance of work;

  • Ancillary expenses including, but not limited to witness fees, expert fees, deposition fees, transcript fees, and interpreter fees may be charged to me, if discussed and approved of by me, in advance of expenses incurred.

  • I have been advised I have the right to retain counsel on my own and there is no requirement I   hire counsel through this program or that I have counsel at all, and that this in no way shape or form establishes an attorney-client relationship with IndyBar or the referring entity.

I will receive the name and contact information for the attorney referred to me within two (2) business days from the date my intake form is submitted to the IndyBar.

Should I desire the assistance of the referred attorney, I must contact the attorney within eight (8) business days of the date my form is submitted by the referring attorney.

When calling the referred attorney, I will specifically reference that I have been referred by the Crisis Empowerment Program.

If it is determined I exceed the minimum income requirements, the IndyBar’s CEP attorney to which I was referred has no requirement to abide by the CEP fee structure, and I am subject to the attorney’s standard hourly rates should I retain the attorney’s services. I further understand the attorney may accept or reject my case without explanation, and I can be referred back to IndyBar so long as the rejection isn’t due to being over income.

This program is made possible by a grant from the Indianapolis Bar Foundation.


Indianapolis Bar Association (IndyBar) est. 1878 | 4,536 Members (as of 2.11.21)