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Solicitors Referral Form

Solicitor/CAB (other Agencies) referral for first appointment with a Mediator

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Please enter email address for confirmation email of details

Client 1 Applicant Details:

Relationship
Relationship
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Client 2 Details:

Relationship
Relationship
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Helpful information about client availability or problems
Helpful information about client availability or problems
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Any allegations of:
Any allegations of:
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Issues for Mediation
Issues for Mediation
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Details of solicitor advising in this matter:

Details of solicitor if known:

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Client's choice of meeting
Client's choice of meeting
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Reason for a separate meeting

If allegations of current domestic abuse a single appointment will be offered

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Phone: 01273 694 661
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Office hours are 09:00 to 17:00 Monday to Friday