Warm Referral Form (Part 2)

Your Contact Details (Referrer)

Referrer Name

Organisation / Firm Name

Nature of organisation / relationship. We are / I am:-

A legal service provider
A support service provider
Other service / professional

Referrer Email Address

Referrer Phone

If you have prepared a summary of the matter and details of referral please attach it here. If any of the upcoming questions are answered in the document, you can just tick or write "See attached".

Drop files here or

Max. file size: 10 MB.

Have you provided the applicant any legal assistance?

Yes
No
See attached

Please provide a brief description of the scope of assistance provided.

In brief, what is the reason you are unable to assist?

Eligibility of the Applicant
Law Access is a means tested service, with very limited exceptions. We consider income and assets.

Do you know whether the applicant's household is of low/no income? Please tick all that apply.

Yes, they are low/no income
No, they are not low/no income
See attached
Unsure

Do you know what assets are owned by the household?

Yes
See attached
Unsure

Assets include housing, cars, money in bank accounts, shares and anything else of value.

Please list assets, their value and any amount they owe for the asset (e.g. a mortgage).

Merit in pro bono referral
Law Access can only help where there is a genuine legal need and the applicant is likely to benefit from pro bono assistance.

What do you consider is the genuine need for pro bono assistance?

There is a genuine cause of action (requires representation)
Needs further advice on prospects or procedure
Requires no merit advice and help withdrawing from legal action
We have not assessed merit
See attached

If you have provided any legal advice on this issue, please attach here where possible (letters, emails or file notes).

Drop files here or

Max. file size: 10 MB.

Step 1 of 3

Your Contact Details (Referrer)

Person Needing Legal Assistance

Special Circumstances

About the Legal Issue