Form – Relationship

Section 1: Your Information

Before we can give you email advice we need to keep accurate records to comply with legislation. Please would you fill out the following details which should take no longer than 5 minutes to complete:-
First
Last
Please leave no spaces when inputting your telephone number.

Section 2: Relationship Enquiry Area

If none, put 0.

Ages of children:

if 'yes' then please list them below, with amount you receive and frequency of payment.

Section 3: Data Protection Act 1998

The law says that we must get your permission to keep some details about you. Everything you tell us will be treated in absolute confidence and all records are stored securely.
If you answer No, we will not be able to provide you with online advice, please call our Advice Line on 0300 330 1179.

Section 4: Conflict of interest

If you are in dispute, we need to know the name of the person. This is because we can’t advise both people, and we also need to make sure our advice and information is fair and impartial.

If applicable, the name of the person I am in dispute with is:

Section 5: Profile

To help improve our services, we need to know whether all groups in the community are being served. We are asking you the questions below so that we can check this. Your answers will only be used anonymously to build up a statistical picture of our clients.

Ethnic Origin:*

(If 'yes', please sepcify in the box below)

Section 6: Submit

It is important to agree for us to properly help you. See our Privacy Policy for more information.
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