Intake Questionnaire

Fall 2023 Open Office Hours

We host on-campus office hours where we accept both walk-ins and scheduled appointments at the following locations. To guarantee a spot, please fill out the questionnaire below.

At MIT, 10am–5pm

Date	Central Campus Location	Floating Location
Sept. 15	Infinite Corridor, 4-144	Urban Studies, 10-401
Sept. 22	Infinite Corridor, 4-144	Media Lab, E14-514
Sept. 29	Infinite Corridor, 4-144	iHQ 6th Floor Conference Room, E38
Oct. 6	Infinite Corridor, 4-144	The Nexus @ Hayden Library, 14S‐130
Oct. 13	Infinite Corridor, 4-144	IDSS, E18-303
Oct. 20	Infinite Corridor, 4-144	Media Lab, E14-514
Oct. 27	Infinite Corridor, 4-144	Urban Studies, 10-401
Nov. 3	Infinite Corridor, 4-144	The Nexus @ Hayden Library, 14S‐130
Nov. 17	Infinite Corridor, 4-144	Media Lab, E14-514
Dec. 1	Infinite Corridor, 4-144	Urban Studies, 10-401

At BU, 2pm–5pm

Date	Room
Sept. 14	BU Spark!, CDS 206C
Sept. 21	BUild Lab, Room 114
Sept. 28	BUild Lab, Room 114
Oct. 5	BU Spark!, CDS 206C
Oct. 12	Kilachand Center (610 Comm. Ave.), Room 106D
Oct. 19	Kilachand Center (610 Comm. Ave.), Room 106D
Oct. 26	BU Spark!, CDS 208
Nov. 2	BUild Lab, Room 114
Nov. 9	BUild Lab, Room 114
Nov. 16	BU Spark!, CDS 208
Nov. 30	BUild Lab, Room 114

Intake Information

Please note that the BU/MIT Student Innovations Law Clinic only represents currently-enrolled students at BU or MIT or projects and ventures that are led or founded by a currently-enrolled BU or MIT student. If you are not a currently-enrolled student at BU or MIT, please do not fill out this form.

Client Infomation
Name of Client*
If you are requesting help on behalf of a group or entity, please use that group/entity’s full name. If you are incorporated, use the corporation’s name.
Primary Contact
Full name*
Address
Street Address Address Line 2 City State ZIP Code
Personal/Venture Email*
Phone
University:*
Course / Department / College:*
Degree Pursued:*
Please note that the BU/MIT Student Innovations Law Clinic only represents currently-enrolled students at BU or MIT
Other Degree*
Anticipated month and year of graduation*
If you are requesting help on behalf of an organization, entity, or group project, what is your role within it?
Legal Question
Please share some background on your project, venture, or other activity related to your legal question. Please include whether aspects of your activity are presently operating or active. Do not disclose any information that you believe to be confidential.*
Briefly describe your legal problems, questions, or concerns. Do not disclose any information that you believe to be confidential.*
Please note any upcoming firm deadlines related to your legal questions.*
Other
Have you or any member of your team worked with the BU/MIT clinical program before? If so, please explain.*
The BU/MIT clinical program have previously included the BU/MIT Technology Law Clinic and BU/MIT Startup Law Clinic
Have you previously worked with any other attorneys or legal services related to this project? If so, please describe.*
How did you find out about us?
Notices
The purpose of this form is to gather initial information to assess whether the BU/MIT Student Innovations Law Clinic (the “Clinic”) is able to represent you in your matter and whether there exist any potential conflicts-of-interests.

Communication via the Internet or this form does not establish an attorney-client-relationship, nor does it guarantee that Clinic or any of its constituents will be able to represent you in this or any other matter.

You are under no obligation to retain the services of the Clinic or any attorney(s) referred to you by the Clinic. You can always obtain counsel from any other source.

If the Clinic refers you to another attorney, you will be represented by that attorney, and not the Clinic. The Clinic makes no guarantees about the nature of legal assistance that attorney may provide.
PLEASE CHECK BOX BELOW INDICATING THAT YOU HAVE READ AND UNDERSTAND ALL OF THE NOTICES ABOVE.*
- Yes

Intake Questionnaire

Fall 2023 Open Office Hours

At MIT, 10am–5pm

At BU, 2pm–5pm

Intake Information

Client Infomation

Primary Contact

Legal Question

Other

Notices