Student Loan Intake

Name:___________________________ Phone:___________________________ Federal Loans: □ None
Potential Discharge:□Disability □Death

Date:____________________________ E-mail:___________________________ Balance:_______________________

□Closed School □Unpaid Refund □False Certification





More affordable payment

Review IBR and other repayment plans


Get current, stay current with affordable payment

Review deferment/forbearance options, and repayment plans

□Deferment □Forbearance

Stay current with affordable payment

Review reason for deferment/forbearance, review repayment plans


Cure default, stay current with affordable payment

Review cure methods: □Consolidation □Rehabilitation
Review repayment plans

□Collection Calls

Stop calls

Name of DC:
Get narrative of collection conduct, have all options been presented properly?


Stop AWG

Review options:
□Hardship hearing
□Temporary cease for consolidation
□Negotiate to cease after certain rehabilitation payments

□Allow w/full rehabilitation

□SS Offset

Stop offset

Apply for hardship determination while curing

□Tax Refund Intercept

Stop intercept

Delay filing taxes until fully cured


Defend and negotiate best outcome

Review pleadings, facts, and client’s individual circumstances □Stipulated agreement
□Defend on the merits (legitimate dispute)

If client is unsure of status or parties involved, send to Attach copies of printout to this form.
If debt collector involved, attach letters and narrative of collection conduct to this form.
If client has multiple federal loans in different status, use additional forms.


Private Loans: □ None Balance:_______________________





More affordable payment

Counsel on lack of options

□Late □Deferment/Forbearance

Get current, stay current

Review client’s budget, is default eminent? Counsel on potential of default. Discuss potential to negotiate better payments, but not always possible.


Cure default or learn of other options

Counsel client on what could happen under State law – lawsuit and post judgment remedies, and prepare for debt collection conduct, etc. Treat as credit card default without bankruptcy option.

□Client has ability to put money aside for potential settlement.

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