Enquiry FormWe often have extended wait times.For urgent enquiries, please call Victoria Legal Aid on 1300 792 387. Name * First Name Last Name Email * Phone * (###) ### #### Were you referred to Q+Law? * Yes No If yes, who referred you to Q+Law? * Date of Birth * MM DD YYYY What is your gender? * You may select from the list below or use the text box below. Woman Man Transwoman Transfeminine Sistergirl Transman Transmasculine Brotherboy Non-binary Genderqueer Genderfluid Gender non-conforming Gender questioning Pangender Agender Prefer not to say Other What is your sexuality? * Queer Gay Lesbian Bisexual/Pansexual Asexual Aromantic Straight Other Applying on behalf of someone who is LGBTQIA+SB Are you Intersex/have an intersex variation? * Yes No Are you trans? * Yes No What are your pronouns? * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Full name of the Other Party (can be a person or organization) * Relationship to the Other Party * Other Party pronouns he/him she/her they/them she/they he/they Any Other Are you experiencing family violence? * Yes No At risk of Is it safe for us to contact you? * Yes - Any Yes - call and voicemail Yes - text message ONLY Yes - email ONLY Yes - Call NO voicemail ONLY No - contact specifications listed in additional supports Are you experiencing homelessness? * Yes No At risk of Do you require any additional supports for your appointment? For example: interpreter, social worker, use of a relay service. Place safe contact instructions here if applicable. What is the main language you speak? * Do you need an interpreter? * Yes No What is your annual income? (estimate) $ Summary of your legal problem What we need: A short paragraph that tells us what has happened, any upcoming court dates, any criminal charges, and what outcome you are looking for. If you find it hard to summarize here that is OK. Write a two-word summary like "criminal law" or "family violence" and our intake worker will call you for more information. What is the best time and method for us to contact you? Thank you for completing this form. Our intake officer will process your information and contact you about an appointment soon. Please note we can only contact you between 9am to 5pm Monday to Friday. Thank you for submitting the Q+Law enquiry form. A staff member will be in contact within the next 48 hours to arrange an appointment with a lawyer where appropriate.
