Attorney First Name (required)

Attorney Last Name (required)

Client First Name (required)

Client Last Name (required)

How many clients are being closed with this case?

—Please choose an option—12345678910

Second Client Name

Third Client Name

Fourth Client Name

Fifth Client Name

What type of service was provided?

Court DecisionMediator DecisionNegotiated Settlement with litigationNegotiated Settlement without litigationBrief ServicesClient Lost ContactClient WithdrewChange in financial eligibilityInsufficient merit to proceed

The outcome for the client was: (required)

—Please choose an option—Quicker Permanency Achieved for ChildBetter Independent Living Services for ChildUnsuccessful

The placement outcome for the client was: (required)

—Please choose an option—AdoptionOPPLA/Independent LivingOPPLA/Long term Licensed CareDeceasedGuardianshipPlacement with RelativesReunificationRunaway/AbscondTransfered to another JurisdictionWithdrawal due to conflictUnsuccessful

Which of the below additional services were provided for the client?

Mental Health- Lessened/Eliminated psychotropic drugs- Obtained release from/prevented RTC placementSiblings- Obtained sibling visitation- Obtained sibling placement togetherServices- DRC- Mojave/Adult mental health- SSIImmigration- Special immigrant juvenile status- U-Visa

What amount was recovered in attorney's fees?

Please report the total pro bono hours for the attorney and case named above:

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Did additional attorneys work on this case?

—Please choose an option—YesNo

Please report the total pro bono hours for any additional attorneys who worked on this case:

Additional Attorney 1:

First Name:

Last Name:

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Additional Attorney 2:

First Name:

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Additional Attorney 3:

First Name:

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Were you aware that you could get CLE credits for completing pro bono cases?

—Please choose an option—YesNo

Does the possibility of getting CLE credits make you more likely to take a pro bono cases in the future?

—Please choose an option—YesNo

If you were aware of the new CLE rule, did the possibility of getting CLE credits influence you to take this case?

—Please choose an option—YesNo

Program Feedback: please provide any suggestions, experiences, or positive or negative feedback that we may use to improve the CAP program.

Additional Comments:

I am willing to take a NEW pro bono case.

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