Attorney Intake Form: Defamation or Slander

By FindLaw Staff | Legally reviewed by Robert Rafii, Esq. | Last reviewed August 17, 2023

This article has been written and reviewed for legal accuracy, clarity, and style by FindLaw’s team of legal writers and attorneys and in accordance with our editorial standards.

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If someone is painting you in a bad light, in print or otherwise, you may have been defamed or slandered. Defamation and slander are personal injury legal claims based on false statements that depend on specific facts. If you can show that statements were false, you may be able to establish tort liability.

Like most personal injury cases, including car accidents, wrongful death claims, and medical malpractice claims, defamation cases can involve complex legal issues. An intake form can make your initial consultation go much easier. Having the form in hand can give your attorney background information. They can then give you a defamation lawsuit retainer agreement or refer you to another lawyer to bring your personal injury claim.

This personal injury attorney intake form can protect your legal rights. Keep in mind the disclaimer that everyone has the right to free speech. They can say true things about you, even if they are bad.

Name:

Address:



Phone Number

Work:

Home:

____________________________________

____________________________________

____________________________________



________________________

________________________
Employer's Name:

Employer's Address:



Work Telephone(s):		 ____________________________________

____________________________________

____________________________________

________________________

________________________
May we contact you at work? Yes _______    No _______

 

Why do you need legal advice about defamation?

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

Section I: If You Think You Have Been Defamed, please answer the following questions.

Did the defamatory statement consist of specific words that were spoken or written?

Yes _______    No _______

 

Please provide our law office with a brief description of the circumstances of the defamatory or slanderous statement and what was said or published.

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

Did the defamatory or slanderous statement consist of some unspoken expression or act that implied something untrue or unsavory about you?

Yes _______    No _______

Please explain the circumstances and describe the defamatory or slanderous act.

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

How long ago did the defamation or slander occur?

In the last year _______

More than one year ago _______

More than two years ago _______

More than three years ago _______

If you know the precise date, please write it here: _________________________________

Did the statement suggest any of the following? Check all that apply.

That you are

a criminal _______

a person of lax morals _______

a drunk or a drug abuser _______

an adulterer _______

an abuser of your spouse or children _______

an unfit parent _______

a liar _______

a thief _______

a cheat _______

Did the statement suggest that you

cheat on your taxes _______

run a shady business, or engage in sharp practices _______

sell adulterated food _______

sell pirated goods _______

cheat your customers _______

swindle elderly people _______

Where was the defamatory statement made?

At work in an open area _______

In a private meeting at work _______

In a performance review _______

At a meeting of your employer's executives _______

In a public place _______

At church _______

In your community _______

At a community meeting _______

Before the city council _______

Before legislators _______

In a communication to a governmental agency _______

In court _______

In a newspaper or magazine _______

In a book _______

Over the radio _______

On TV _______

On the internet (e.g., social media) _______

How did you find out about the statement?

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

Who heard, read, or saw the defamatory statement? Please be specific.

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

Was the defamatory statement directed toward your business?

Yes _______    No _______

Do you think that the defamatory statement could have had a negative impact on your business?

Yes _______    No _______

Section II: If you are being sued, please answer the following questions.

What was going on when the alleged defamatory statement was made? What were the circumstances?

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

 

How long ago did the defamation occur?

In the last year _______

More than one year ago _______

More than two years ago _______

More than three years ago _______

If you know the precise date, please write it here: _________________________________

Who is the plaintiff, and what does he or she do?

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

Is the plaintiff a public official?

Yes _______    No _______

Is the plaintiff somebody well-known?

Yes _______    No _______

Where did the alleged defamatory statement take place? (Consult the list in Section I.).)

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

Who else heard you make the alleged statement? Who read it? Who saw it?

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

Was the statement true? If it was, please explain why you think it was true.

Yes _______    No _______

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

Where did you get the information that formed the basis for the alleged defamatory statement?

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

Did you confirm the information with a third person?

Yes _______    No _______

Did you try to keep the information confidential if it was, in fact, given to you in confidence?

Yes _______    No _______

 

Does your liability insurance company cover defamation?

Yes _______    No/Not Sure _______

No matter how you answer this question, have the policy, along with any amendments or riders to it, with you to the first meeting with your attorney.

 

Keep in mind that you have a limited time in which to bring a personal injury lawsuit, including a defamation claim, in court. The amount of time is set in your state's statute of limitations. So act quickly to obtain an initial consultation or attorney referral.

A personal injury lawyer will look at your situation and determine if you should win your defamation claim. Winning will depend on the harm to your reputation, the financial and emotional distress suffered, and any physical injury. A skilled lawyer may be able to recover compensatory and punitive damages for you.

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