Law Clinic Enquiry Form

Law Clinic Enquiry Form

Please use the form below to send us details of your enquiry and someone will get back to you as soon as possible.
Filling out the form:

Please note that we will need a working telephone number and email address with which to be able to contact you.

Please also disclose whether you have any contact requirements e.g. not wanting to be contacted via phone, not wanting to have messages left or whether you wish to only be contacted via email.

Fields marked * are required fields.
Area of Law that you need help with (multiple choice):
Can we contact you by phone?
Can we leave a voicemail?
Can we contact you by email?
Your Name

First NameLast Name
Address

1st line of Address

2nd Line of Address

Town/CityCounty

Post Code
Phone Number

Area CodePhone Number
Email
example@example.com
Your problem
Please provide details of your problem and what help you need.
Do you have a file to upload?

Cancelof
Please provide the full name and address of any third party involved in your problem. If not known, please state 'unknown' or 'N/A':
Data protection

Data protection requires you to read this statement and provide your agreement around our collection and storage of your data.

Under the GDPR rules we need to ask your permission to collect and retain personal details. These are recorded on secure systems and are only available to those with a business need. You can withdraw consent to your information being used in a particular way at any time but this may limit what more we can do for you (if anything). A full copy of our GDPR policy is available upon request.
Do we have your permission to collect and retain your personal details?
Third Party Authorisation

To ensure your 30 minute appointment can be used most efficiently this form needs to be forwarded to the legal practitioner who will be helping you.

We will only do so with your consent to share this with them, along with any other information you may share with us when our coordinator contacts you to clarify any details and/or make the appointment.
Do you agree to this form being shared with a third party
Please verify that you are human
Should be Empty: