Direct Access Referral Form

Please complete all fields

1) Your Name

2) Your Home / Postal Address

3) Your Telephone Number(s)

4) Fax Number (optional)

5) Email Address

6) Nature of Case (please select)
Children (including residence and contact on separation)
Vulnerable & Elderly People
Trusts
Money Issues on Separation & Divorce
Separation & Divorce
Education
Other (please specify below)

7) Assistance Sought
Written Advice
Conference / Face to Face Meeting
Drafting of Documents (please specify below)

Representation at Court (please indicate all known future court hearings below)

8) Full names of other parties involved

9) Full names of children who are the subject of the proceedings and dates of birth

10) Names and contact details of any solicitors involved (please indicate which party they represent)

11) Have you instructed a Solicitor or a Barrister before on this matter?
Yes
No

12) If you have answered Yes to question 11, did you qualify for Legal aid?
Yes
No