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

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?

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 noone else involved in your legal issue, please say "not applicable". PLEASE LIST ALL CHILDREN HERE.

This may include children, other family members or people who are not related to you

Your contact number

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

What are the safe ways we can contact you?

Please hold down the 'ctrl' button if you need to select more than one safe way that we can contact you. Please provide the contact details for your support worker in the box at the bottom of the form if we cannot contact you directly

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

Do you consider yourself to have a disability, impairment or long term condition?

Do you identify as Aboriginal and/or Torres Strait Islander?

Which country were you born in?

Which language do you mainly speak in?

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?

Do you work full-time or part-time?

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

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