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	<p class="titleheader">
Schedule a Consultation 
</p>
<p>
Request a consultation with one of our attorneys using the form below. If you are a current client please call our office toll free at
866-261-8282 to schedule an appointment with the Attorney working on
your case, as their individual schedules vary. 
</p>
<p>
All appointments will be confirmed via e-mail within 24 hours and courtesy confirmation calls are typically placed the day before the scheduled appointment time.
</p>
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		<p>Please fill out this form</p>
		<p>Items marked with a <span class="error">*</span> are required.</p>
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	<input type="text" name="Name">
		<lable>Your Name</lable>
		<rule name="required" errorTxt="Please supply your name"/>
	</input>
	<input type="text" name="Phone">
		<lable>Phone Number</lable>
		<rule name="required" errorTxt="Please supply your phone number"/>
	</input>
	<input type="text" name="emailAddress">
		<lable>Your Email Address</lable>
		<rule name="required" errorTxt="We need your email address to respond to your request"/>
		<rule name="validemail" errorTxt="Please check your email address"/>
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	<textblock>
		<p><strong>Select an Office</strong></p>
	</textblock>
	<repeater id="classes" name="Location" type="radio">
		
		<input type="radio" name="Location" value="Southfield">
			<lable><b>Southfield</b><br/>Monday-Thursday 9:00 a.m. - 7:00 p.m.<br/>Friday: 9:00 a.m. - 5:00 p.m.<br/>Saturday: 9:00 a.m. - 3:00 p.m.</lable>
		</input>
	
		
		<input type="radio" name="Location" value="Flint">
			<lable><b>Flint</b><br/>Monday-Tuesday 9:00 a.m. - 6:00 p.m.<br/>Wednesday 10:00 a.m. - 7:00 p.m.<br/>Friday: 9:00 a.m. - 5:00 p.m.</lable>
		</input>
	
		
		<input type="radio" name="Location" value="Dearborn">
			<lable><b>Dearborn</b><br/>Monday-Thursday 9:00 a.m. - 7:00 p.m.<br/>Friday: 9:00 a.m. - 5:00 p.m.<br/>Saturday: 9:00 a.m. - 3:00 p.m.</lable>
		</input>
	
		
		<input type="radio" name="Location" value="Warren">
			<lable><b>Warren</b><br/>Monday, Tuesday, Thursday, Saturday By Appointment<br/>Wednesday 10:00-7:00 p.m.<br/>Friday 9:00-5:00 p.m.</lable>
		</input>
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	<textblock>
		<p><strong>Select your prefered date and time</strong></p>
	</textblock>
	<input type="date" name="Date">
		<lable>Date of Consultation</lable>
		<rule name="required" errorTxt="Please choose a date"/>
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	<repeater id="Time" name="Time" type="select" lable="Select a time">
		
		<option value="9:00 AM">9:00 AM</option>
	
		
		<option value="9:15 AM">9:15 AM</option>
	
		
		<option value="9:30 AM">9:30 AM</option>
	
		
		<option value="9:45 AM">9:45 AM</option>
	
		
		<option value="10:00 AM">10:00 AM</option>
	
		
		<option value="10:15 AM">10:15 AM</option>
	
		
		<option value="10:30 AM">10:30 AM</option>
	
		
		<option value="10:45 AM">10:45 AM</option>
	
		
		<option value="11:00 AM">11:00 AM</option>
	
		
		<option value="11:15 AM">11:15 AM</option>
	
		
		<option value="11:30 AM">11:30 AM</option>
	
		
		<option value="11:45 AM">11:45 AM</option>
	
		
		<option value="12:00 PM">12:00 PM</option>
	
		
		<option value="12:15 PM">12:15 PM</option>
	
		
		<option value="12:30 PM">12:30 PM</option>
	
		
		<option value="12:45 PM">12:45 PM</option>
	
		
		<option value="1:00 PM">1:00 PM</option>
	
		
		<option value="1:15 PM">1:15 PM</option>
	
		
		<option value="1:30 PM">1:30 PM</option>
	
		
		<option value="1:45 PM">1:45 PM</option>
	
		
		<option value="2:00 PM">2:00 PM</option>
	
		
		<option value="2:15 PM">2:15 PM</option>
	
		
		<option value="2:30 PM">2:30 PM</option>
	
		
		<option value="2:45 PM">2:45 PM</option>
	
		
		<option value="3:00 PM">3:00 PM</option>
	
		
		<option value="3:15 PM">3:15 PM</option>
	
		
		<option value="3:30 PM">3:30 PM</option>
	
		
		<option value="3:45 PM">3:45 PM</option>
	
		
		<option value="4:00 PM">4:00 PM</option>
	
		
		<option value="4:15 PM">4:15 PM</option>
	
		
		<option value="4:30 PM">4:30 PM</option>
	
		
		<option value="4:45 PM">4:45 PM</option>
	
		
		<option value="5:00 PM">5:00 PM</option>
	
		
		<option value="5:15 PM">5:15 PM</option>
	
		
		<option value="5:30 PM">5:30 PM</option>
	
		
		<option value="5:45 PM">5:45 PM</option>
	
		
		<option value="6:00 PM">6:00 PM</option>
	
		
		<option value="6:15 PM">6:15 PM</option>
	
		
		<option value="6:30 PM">6:30 PM</option>
	
		
		<option value="6:45 PM">6:45 PM</option>
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	<input type="submit" name="Submit" value="Submit"/>
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