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Home
About
Services
Divorce & Separation
Family Mediation (FDR)
Parenting & Child Support
Property Settlements
Wills & Estates
De Facto Relationships
Orders by Consent
Court Proceedings
Recovery Orders
Fees & Prices
Resources
Resources & Articles
Divorce Guide
Family Mediation Guide
De Facto Relationship Guide
Client Intake Form
Contact
Noosa
Cooroy
Client Intake Form
Free Consultation
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Client Intake Form
Your Details
Name
(Required)
First
Middle
Last
Other Names
eg maiden name, previous names etc
Date of Birth
(Required)
DD slash MM slash YYYY
Gender
(Required)
Male
Female
Other
Employment Status
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Employed
Retired
Centrelink
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Occupation
(Required)
Employer
Address
(Required)
Street Address
Address Line 2
Suburb
State
Postcode
Email
(Required)
Phone
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Safe Contact & Emergency Details
Preferred contact method
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Email
Phone
Safe to leave voicemail?
(Required)
Yes
No
Safe to send emails?
(Required)
Yes
No
Alternative safe contact details
Emergency contact name
Emergency contact phone
Other Party's Information
Name
(Required)
First
Middle
Last
Other Name
eg maiden name, previous marriages etc
Date of Birth
DD slash MM slash YYYY
Gender
(Required)
Male
Female
Other
Address (if known)
Street Address
Address Line 2
Suburb
State
Postcode
Email
Phone
Relationship Information
Commencement of Cohabitation
(Required)
DD slash MM slash YYYY
Date of Marriage (if applicable)
DD slash MM slash YYYY
Place of Marriage
Date of Separation
DD slash MM slash YYYY
Date of Divorce
DD slash MM slash YYYY
De-facto Relationship Commencement
DD slash MM slash YYYY
De-facto Relationship End (if applicable)
DD slash MM slash YYYY
Any Previous Court or DV Orders?
Yes
No
Children's Information
Child's Name
Full Name
Date of Birth
DD slash MM slash YYYY
Lives With
Child's Name
Full Name
Date of Birth
DD slash MM slash YYYY
Lives With
Child's Name
Full Name
Date of Birth
DD slash MM slash YYYY
Lives With
Add another child?
Add another child?
Child's Name
Full Name
Date of Birth
DD slash MM slash YYYY
Lives With
Add another child?
Add another child?
Child's Name
Full Name
Date of Birth
DD slash MM slash YYYY
Lives With
Existing Parenting Arrangements
Informal
Parenting Plan
Consent Orders
Court Orders
Matter Type
I am seeking advice in relation to
(Required)
Parenting
Property
Divorce
Mediation
Domestic Violence
Child Support
Court Proceedings
Wills / Estate
Financial Agreement (BFA)
Other
Family Violence Orders?
Yes
No
Unsure
Details
(Required)
Have you attended mediation?
Yes
No
No, but mediation is arranged
Desired Outcome
Overview of Issues & Desired Outcome:
Urgency
Do you have any urgent deadlines?
(Required)
Court date
Mediation
Safety concerns
Other
Please specify
(Required)
Date of deadline
DD slash MM slash YYYY
Document Checklist
Photo ID (license or passport)
Divorce certificate
Marriage certificate
Family law or DV Court orders
Any correspondence from the other party or their lawyer
Please provide (if available) by sending to admin@nhfamilylaw.com.au.
I confirm that the information provided in this form is true and correct to the best of my knowledge, and I consent to Noosa & Hinterland Family Lawyers collecting and storing my personal information for the purpose of providing legal services.
Agreement - Your Name
Terms & Conditions
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