Fairfax Bar Association
Referral Information Form

Please fill out and submit this form to have a staff member from the Fairfax Bar Lawyer Referral Service contact you.  If you prefer, you may call the service directly at 703-246-3780 between the hours of 9:00 AM-4:00 PM Monday-Friday.  Please note that fields with asterisks (*) are required fields. 

Disclaimer: The Fairfax Bar Association's website is designed to provide general information to the public and is not intended to offer legal advice.  Filling out the Referral Information Form does not create an attorney client relationship.  If your legal problem is an emergency, you should consult an attorney immediately.  Under normal circumstances, we will contact you to arrange a referral within 1-2 working days.

Full Name *
Address *
City *
State *

Zip Code *
Work Phone *
Home Phone *
Cell/Mobile/Pager *
Preferred Method of Contact *

Please tell us what kind of legal problem you have by selecting one or more of the options below.

Type of Legal Problem *

Best Time to Contact You *

Please feel free to submit additional comments which may further assist us in finding an attorney best suited for your needs.

Additional Comments


4110 Chain Bridge Rd, Suite 216
Fairfax, VA 22030

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Local: 703-246-2740
Fax: 703-273-1274
Email: fba@fairfaxbar.org

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