LEGAL NOTICE

BY SUBMITTING THIS INTAKE INTEREST QUESTIONNAIRE FORM, I HAVE READ AND AGREE TO THE FOLLOWING:

AGREEMENT

I CERTIFY THAT I AM AT LEAST 18 YEARS OF AGE.  I FULLY UNDERSTAND SOVEREIGN SOLUTIONS, LLC IS A NON-ATTORNEY AGENCY AND DOES NOT PROVIDE ANY LEGAL ADVICE, LEGAL REPRESENTATION, CLAIMS, OR GUARANTEES.  

PRIVACY POLICY

DEPENDING ON WHICH SERVICES YOU USE, WE COLLECT DIFFERENT KINDS OF INFORMATION FROM AND ABOUT YOU.  WE USE THE INFORMATION WE HAVE TO HELP US PROVIDE AND SUPPORT OUR SERVICES.  WE WORK WITH THIRD PARTY COMPANIES WHO HELP US PROVIDE AND IMPROVE OUR SERVICES.  WE STORE DATA AS REQUIRED BY LAW AND FOR AS LONG AS IT IS NECESSARY TO PROVIDE PRODUCTS AND SERVICES TO YOU AND OTHERS.  WE MAY ACCESS, PRESERVE AND SHARE YOUR INFORMATION, INCLUDING IN RESPONSE TO A LEGAL REQUEST (SUCH AS A SEARCH WARRANT, COURT ORDER OR SUBPOENA) IF WE HAVE GOOD FAITH BELIEF THAT THE LAW REQUIRES US TO DO SO.  LEARN MORE ABOUT YOUR PRIVACY HERE.

BILLING

I CONFIRM MY AUTHORITY TO USE THE DEBIT OR CREDIT CARD PROVIDED, AND I HEREBY AUTHORIZE THIS PURCHASE.  BY SUBMITTING THIS INTAKE INTEREST QUESTIONNAIRE FORM, I GIVE SOVEREIGN SOLUTIONS, LLC PERMISSION TO VERIFY MY INSURANCE COVERAGE AND/OR CHARGE MY ACCOUNT.  

SOVEREIGN SOLUTIONS, LLC WILL AUTOMATICALLY CHARGE MY DEBIT OR CREDIT CARD FOR ANY REMAINING BALANCE OWED TO SOVEREIGN SOLUTIONS, LLC.  I AGREE THAT IN THE EVENT MY DEBIT OR CREDIT CARD BECOMES INVALID, I WILL PROVIDE A NEW VALID DEBIT OR CREDIT CARD TO SOVEREIGN SOLUTIONS, LLC UPON REQUEST, TO BE CHARGED FOR THE PAYMENT OF ANY OUTSTANDING BALANCE OWED TO SOVEREIGN SOLUTIONS, LLC.

TERMS & CONDITIONS

I UNDERSTAND SOVEREIGN SOLUTIONS, LLC RESERVES THE RIGHT TO REFUSE SERVICES, TERMINATE SERVICES AND ACCOUNTS WITH OR WITHOUT NOTICE, REMOVE OR EDIT SERVICES AND CONTENT OFFERED, AND CANCEL ORDERS IN ITS SOLE DISCRETION.

DISCLAIMER

CONFIDENTIAL OR TIME-SENSITIVE INFORMATION SHOULD NOT BE SENT ELECTRONICALLY OR VIA ANSWERING SERVICE.  IF I AM IN CRISIS, I WILL DIAL 911, IMMEDIATELY, AND SEEK HELP AT AN EMERGENCY ROOM.  USING THE INFORMATION BELOW, A PHONE CONSULTATION MAY BE SCHEDULED.

Interest Form

If you are in crisis, please use a phone and dial 911 for emergency assistance.

Please identify your service interest.

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