ATTORNEY APPLICATION****

Our online directory is open to attorneys who offer full representation, unbundled services or limited appearances (as approved by Administrative Order 14-10) to modest-means clients. Modest-means clients are clients with annual incomes between 200%-400% of the Federal poverty levels.

Step 1: Agree to Terms and Conditions
You agree to promptly let a prospective client know whether or not you have accepted them as your client. *

Yes
You agree to enter into a written fee agreement with clients. *

Yes
You understand that DC Refers may ask your clients to evaluate your services. *

Yes
You understand that you must maintain your status as an active member of the D.C. Bar (and/or other Bar membership). *

Yes
You agree to contact us if you want to temporarily or permanently remove your profile from our site. *

Yes
You agree to remit to DC Refers a fee of $50 for participation in DC Refers. *

Yes
You agree to complete periodic surveys or evaluations of DC Refers. *

Yes
You understand that not complying with any of the above terms is grounds for removal from this directory. Additionally, you understand that you can be removed from the directory for cause. *

Yes
You agree to indemnify and hold harmless the DC Refers Board of Directors and its agents from any claim, loss, damage, expense or injury to any person, or property of any person, injured through any negligence committed, omissions, or acts undertaken while performing mediation services on behalf of an individual referred to you by DC Refers. *

Yes

Step 2: Bar Membership/Location
Full Name *

First Name Last Name
Your Phone Number *

Area Code Phone Number
Identify which email address you would like us to send application updates to: *
Website address
Are you an active member of the D.C. Bar? *

Yes No, I am not a member of the D.C. Bar nor the Federal Bar

Step 3: Description of Your Services/Practice
List out each major practice area and your respective years of experience. Please also note what type of work you do within that practice area: *
What kinds of cases do you accept? Select all/type in the kinds of cases you accept. *
If you selected other, please specify here:
If you offer limited appearances or unbundled services, list here with their respective cost.
Optional
Attach a document describing the hourly rate you will charge for clients whose incomes are between 200-400% of the federal poverty guidelines. If you offer multiple rates, clearly list out your full rate schedule and/or sliding scale fees. *

Upload a File
Your hourly rate/rate schedule will be used internally only. Clients will not be able to see your hourly rate/rate schedule. Cancel of

Step 4: Malpractice Insurance
Do you currently have malpractice insurance of at least $100,000 per claim/$300,000 aggregate? *

Yes No

Step 5: Upload Attachments
Attach a copy of your declaration (“dec”) page from your most recent professional liability insurance policy *

Upload a File

Cancel of
Attach resume *

Upload a File

Cancel of

Step 6: List Your References
Please provide two professional references and two client references. Examples of professional references include: judges, former employers, co-workers or colleagues.
Professional Reference #1 *

First Name Last Name
Phone Number *

Area Code Phone Number
E-mail
Professional Reference #2 *

First Name Last Name
Phone Number *

Area Code Phone Number
E-mail
Client Reference #1 *

First Name Last Name
Phone Number

Area Code Phone Number
E-mail
Client Reference #2 *

First Name Last Name
Phone Number

Area Code Phone Number
E-mail

Step 7: Press Submit to Pay Fee
Application Fee *
prev next ( X )
Non-Refundable Application Fee $ 50.00
How did you hear about our pilot program? *

D.C. Bar website Ad in the Washington Lawyer Magazine DC Consortium List Serve Referred by a Colleague Other
Please specify what organization referred you to our service:
Media Consent

From time to time DC Refers highlights a member attorney on its Facebook page and Twitter feed, or otherwise tries to increase awareness of our member lawyers and our service. If you would like to participate in these activities, please check the following checkbox:
*

I give the DC Reduced Fee Lawyer and Mediator Referral Service (DC Refers) permission to use my name, likeness, biography and other non-proprietary information on the web, in print, and on social media for the purpose of increasing awareness of the online directory and to otherwise further the mission of DC Refers. I do not consent.
Should be Empty:

Now create your own Jotform - It's free! Create your own Jotform

Unfortunately, you are not eligible to join our directory.