I understand that I am participating in a Student Legal Services Clinic. I am meeting with a law student working under the supervision of a licensed attorney. All information is strictly confidential.

I further understand that Student Legal Services is not representing me in any capacity as a result of today's meeting. Any advice or opinion I receive is based upon the limited facts and circumstances I present to the intern and is not the product of investigation into the facts or law involved, but is merely a qualified opinion drawn from the resources immediately available to the legal intern. I also understand that consultations are free, but that there will be a ten dollar ($10.00) charge per consultation if I use Student Legal Services three times or more during a semester for the same issue as this consultation today.