SuiteDash - Submit Form

Please fill out the form below. Note that any question with a * is REQUIRED, and must be completed before you are able to submit the form and confirm your appointment.

What areas are you interested in? If multiple, please choose one here and list the rest in the "other" section.

Please provide your HCBS license number. A 245D license is necessary in order to apply for ICS. We are unable to speak with you regarding ICS services if you do not have a current HCBS license number.*

You chose Monthly General Counsel Program. Your appointment will be with Attorney David Holt. You will be able to schedule your appointment at the end of this form.

You chose Medical Spa. Your appointment will be with Attorney David Holt. You will be able to schedule your appointment at the end of this form.

You chose Medical Practice. Your appointment will be with Attorney David Holt. You will be able to schedule your appointment at the end of this form.

You chose Behavioral Health. Your appointment will be with Attorney Jamie Christopher. You will be able to schedule your appointment at the end of this form.

You chose 245D. Your appointment will be with Paralegal Courtney Gilman. You will be able to schedule your appointment at the end of this form.

You chose Other. Your appointment will be with Attorney David Holt. You will be able to schedule your appointment at the end of this form.

You chose ARMHS/CTSS/EIDBI/HSS. Your appointment will be with Paralegal Courtney Gilman. You will be able to schedule your appointment at the end of this form. Please choose the area you are most interested in:

Please choose which area you are interested in:*

You chose ICS. Your appointment will be with Senior Executive Paralegal Caitlin Powell. You will be able to schedule your appointment at the end of this form.

You chose IRTS/245G. Your appointment will be with Associate Attorney Jamie Christopher. You will be able to schedule your appointment at the end of this form.

Please choose the area you are interested in:*

You chose Assisted Living. Your appointment will be with Associate Attorney Jamie Christopher. You will be able to schedule your appointment at the end of this form.

You chose Independent Contractor vs. Employee. Your appointment will be with Associate Attorney Jamie Christopher. You will be able to schedule your appointment at the end of this form.

You chose Recuperative Care. Your consultation will be with Attorney David Holt.

If you chose "other" please describe. If you have multiple categories you are interested in, please list the additional areas here as well.*

Provide a BRIEF description of the matter (no more than 3 sentences total).*

First Name*

Last Name*

Email*

Phone*

If you were referred, who referred you?

Company Name

Are you representing a Company? Complete this field with your Company Name. Or, if you are doing business as an Individual, then leave this field blank.

When scheduling your appointment, please note that we are located in the CENTRAL time zone (America/Chicago).

When choosing a date and time, please be sure it is a time and date that you are able to attend and there is no reason, except for an emergency, that you would not attend. We do not allow free reschedules, except for emergencies.

*By clicking "Submit" you consent to receive SMS communication from Holt Law.

Make an Appointment: You will be able to choose from available Appointments on the next step