Debt or money problem: Advice for someone else

Client Contact Details

First Name

Last Name

Address

Suburb

State

Postcode

Phone Number

Email Address

Is it safe to phone, text and email?

If not, how can we safely make contact?

How did you hear about us?

Full name of person, government agency or company they are in dispute with

What is their legal matter about?

Details of their matter

What questions do they have?

Have they received advice from another organisation about this matter?

Date of Birth

Gender

Preferred Pronouns

Country of Birth

Main language spoken at home

Aboriginal and Torres Strait Islander Status

Are they an International Student?

Education Provider

Disability Status

Centrelink Status

Employment Status

Income Level

Your name

What is your relationship to the person with the legal matter?

Your email address

Your phone number

Who should we contact about the advice appointment?

Is an interpreter needed?

What language?