Who is your consultation with?*

What is the main area of law that you wish to discuss with us?*

Your Name*

Your Date of Birth*

Your Email Address*

Your Phone Number*

Your Address*

Are you….?*

Do you live in the family home?*

Your Occupation*

Your (ex)partner’s Details

Name*

Date of Birth*

Does your (ex)partner live in the family home?*

Address*

Email

Phone

Occupation

Does your (ex)partner have a solicitor?*

Name of Solicitor’s firm (if known)

Are there children of the relationship?*

How many children do you have?*

Children

Child’s Details*

Child Two’s Details*

Child Three’s Details*

Child Four’s Details*

Who does your child live with for the majority of the time?*

Who do the children live with for the majority of the time?*

Details of Marriage

Date of Marriage*

Date you commenced living together (approx)

Date of separation (if applicable)

Details of Civil Partnership

Date of Civil Partnership*

Date you commenced living together (approx)

Date of separation (if applicable)

Former Family Home

Please explain what has happened with the former family home

Family Home

Is the family home owned or rented?*

Whose name is on the tenancy?*

Is the property registered in a sole name or joint names?

As the property is in a sole name,who owns it?

Date of Purchase (approx)

Current Value (approx)

Is the property mortgaged?

Mortgage Balance (approx)

Financial Details

Any other assets or liabilities you wish to bring to our attention at this stage?

What is the usual pattern of contact (if there is one)?*

Provide a brief overview of the current dispute.*

Dispute

Provide a brief overview of the current dispute.*

Mediation & Court

Have you and your partner been to mediation?*

Please provide more details on the outcome of mediation

Have any court proceedings been commenced?*

Who has commenced the court proceedings?*

Please provide a brief overview of what has taken place so far in the proceedings

Further Comments

Any further comments you wish to make?

Email

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Relationship Breakdown

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Cases Involving Children

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