Referral

We ask you to fill out this form so we can work out if we can support you with your legal problem and if you are eligible for our services.

The information you provide here will be confidentially and safely saved in our system. Our administrative staff, paralegals and lawyers will use this information to contact you, make an appointment with a lawyer and work out how we can assist you.

We aim to get in touch with you within 5 business days of you submitting this form.

Enquiry date

Please note that we are unable to assist you if you 1. Earn more than $1,200 a week from salary and/or benefits; OR 2. Have been or were in a relationship with the other party for 7-10 years or more AND there is more than $500,000 equity in the family home; OR 3. Already have a lawyer

What do you need legal help with?

Please hold down the 'ctrl' button if you need to select more than one area that you need legal help with

Do you have any legal matters in Court at the moment?

When is your next Court date?

Which Court do you need to go to?

What type of hearing is it?

It could be a mention, directions hearing, final hearing/contest. If you are not sure, please say "I don't know"

Your first name

Your last name

Your preferred name

Your date of birth

First name of the other person who is involved in your legal issue

Last name of the other person involved in your legal issue

Date of birth of the other person involved in your legal issue

What is your relationship to this person?

What is the first name of your current partner?

If you do not have a current partner, please write 'not applicable'.

What is the last name of your current partner?

If you do not have a current partner, please write 'not applicable'.

What is your current partner's date of birth?

If you do not have a current partner, please enter "1/1/1900".

Please provide the first name, last name and dates of birth for all of your CHILDREN (including any step-children) here. If you do not have children, please say "not applicable".

Please provide the first name, last name, date of birth and information about your relationship to the person, for any other people involved in your legal issue. If there is no-one else involved in your legal issue, please write "not applicable". This may include other family members or people who are not related to you.

What is your address?

Which suburb do you live in?

Which state do you live in?

What is the postcode for where you live?

Your contact number

Your email (if you do not have one, write "do not have one")

Is it safe for us to call you on the phone number you have given us?

Is it safe for us to leave you a voicemail?

Is it safe for us to send you an SMS?

Is it safe for us to send an email to you?

When is a safe time to call you? If it is not safe to call you, please tell us and we will be in touch by email to make alternative arrangements

Your gender

If you would prefer, please describe your gender in your own words

Your pronouns

Are you Aboriginal and/or Torres Strait Islander?

What is your country of birth?

What is the main language you speak at home?

If the language you need is not in the list above, please tell us what language you need here

Do you require an interpreter

Are you currently employed?

Are you receiving Centrelink payments? If so, what type of payment/s are you receiving?

What is your average weekly income?

This includes income from Centrelink and/or your employer

Do you have a support worker?

If you have a support worker, what is their name and which organisation are they from?

If you do not have a support worker, please write 'not applicable'

Is there anything else you would like us to know at this point?