Arent Fox LLP Office Hours | 2013 mHealth Summit

During this year's mHealth Summit, entrepreneurs will have an opportunity to get some of their legal questions answered compliments of the legal team at Arent Fox. For three days, in Booth 1234 of the Exhibit Hall we will be hosting a series of “office hours” for entrepreneurs and start up companies attending the summit. We have partnered with Arent Fox to provide an unique service to our entrepreneurial companies, the chance to get some legal questions answered without the burden of initial high costs.

To be considered for office hours, please fill out the registration form below. Each application will be reviewed and run through a rigorous conflicts process to assure that, if accepted, you will be receiving fair and unbiased counsel from the Arent Fox team.

Applications are due by November 23 and you will be notified by November 30.

Name of Representative attending the office hours (Will receive all information pertaining to office hours): *

Name of additional Representative attending office hours: *

Company Name: *

Company Address: *

Contact Email Address: *

Mobile Phone: *

Stage of Business: *

Governance Structure: *

Number of Employees: *

Nature of Legal Question(s): *

Other Question:

Overview of Legal Issues to be Discussed: *

Additional Relevant Documents :

First Choice: Select preferred date and time for office hours: *

Second Choice: Select preferred date and time for office hours: *

Third Choice: Select preferred date and time for office hours: *

IMPORTANT. PLEASE READ: Please note that you and we do not currently have an attorney-client relationship, and your submission of the information on this form does not constitute or form an attorney-client relationship. Please do not convey to us any sensitive confidential information via this electronic form. Unless otherwise agreed, for purposes of your submission and any future conversations, we view you as a prospective client and any discussions that we have on the matters described in this form are intended to be subject to the attorney-client privilege covering communications between attorneys and prospective clients, to the fullest extent possible. If we determine, on the basis of the information you provide, that it is preferable to form a formal attorney-client relationship prior to, or after, meeting with you, we will circulate for your execution an attorney-client engagement letter, which will set forth the terms of that engagement. Any consultation at the mHealth Summit scheduled as a result of your submission will be without charge. Please note that not all applicants are guaranteed to receive a consultation at the mHealth Summit, as ethical obligations to existing clients may create a conflict of interest, or other considerations, including the number of applicants, may prevent us from meeting with certain interested applicants. By submitting your application, you agree to these terms and conditions.