SPECIAL CIRCUMSTANCES

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About Your Legal Issue

CONSENTS AND PERMISSIONS

Authority Form
The person you are referring will need to sign our authority form. The authority form can be completed separately online or downloaded as a PDF (which can then be uploaded or emailed or posted to us). Click here to go to the authority form

By signing the box at the bottom of this form I accept that:

1. Law Access relies on the information that I provide and I must provide full disclosure of all relevant information to Law Access to process my application.
2. Law Access may need to get other information about me or my legal issue and I provide the consent below for my information to be shared with Law Access.
3. Law Access may share information about my application with others for the purpose of processing my application.
4. Law Access may publish information about my application for reporting, marketing and promoting Law Access work and pro bono practice but when they do so they will not use my name or other information that would allow me to be identified unless I specifically agree to be identified.
5. Law Access will keep my information confidential and use it only for my application and not for processing any application by any other applicant.
6. Law Access may receive or possess information for others whose interest conflict with mine and will not use their information in processing my application. Law Access may still process applications when this happens.
7. Where there is a conflict of interest, Law Access may refer my application to an independent external party for assessment.

I authorise and request any person or organisation holding relevant information about me to provide Law Access any information and documents Law Access request in order to assist Law Access to process my application for pro bono assistance and to collect information about outcomes.