Enquiry Form

If you are a worker referring a client, please do not use this form. Instead, please see the contact us page for details.

For urgent enquiries, please call Victoria Legal Aid on 1300 792 387.

Name

First Name

Last Name

Phone

(###)

###

####

Were you referred to Q+Law?

Yes

If yes, who referred you to Q+Law?

Date of Birth

YYYY

What is your gender?

You may select from the list below or use the text box below.

What is your sexuality?

Are you Intersex/have an intersex variation?

Yes

Are you trans?

Yes

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

Are you experiencing family violence?

Is it safe for us to contact you?

Are you experiencing homelessness?

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

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 for us to call you?

We can only contact you between 9am to 5pm Monday to Friday. Please note we cannot complete intake or provide legal advice via email or text. If you would prefer to complete your intake in person we can organize a time to do so via written communication methods.