Your Personal Details

First Name *

Last Name *

Address

Street Address

City

State

Country

Postal code

Have you ever been known by another name?

Yes, I have.

No, I haven't.

If yes, please state your other name:

Date of birth *

Best Contact Number *

I consent to receive SMS notifications, alerts, and occasional marketing communications from Aqua Legal & Conveyancing.

Alternate Contact Number (if applicable)

Work Number

Email Address

What is your occupation? *

Information About the Other Party (If Applicable)

Full Name *

Have he/she ever been known by another name?

Yes

If yes, please enter his/her other name

Postal Address

What is his/her best contact number

Alternate Contact Number (if applicable)

What is his/her work number?

What is his/her email address?

What is his/her date of birth

What is his/her occupation?

Does the other party have a solicitor?

Yes

Unsure

If yes, please provide their name and contact details.

Children (If Applicable)

Do you and the other party have children together?

Yes, I do.

No, I don't.

If yes, please list their full names and dates of birth.

Do you have children with someone else?

No, I don't.

Yes, I do.

If yes, please list their full names and dates of birth.

Does the other party have children with someone else?

Yes, they do.

No, they don't.

Unsure

If yes, please list their full names and dates of birth.

Relationship Details (If Applicable)

When did you and the other party start living together?

When did you and the other party separate?

Were you married?

Yes

If yes, when did you and the other party get married?

Are you divorced?

Yes

If yes, what date were you and the other party divorced?

If no, what date did you and the other party separate for the final time?

Previous Legal Advice & Resolution Preferences

Have you already received legal advice about this matter?

Yes

If yes, who provided the legal advice?

What do you consider to be the best outcome for your situation?

Have you considered how you would like to resolve your situation?

No, I haven’t thought about it yet.

Yes, I have.

Would you like more information about resolution options?

Yes

If yes, which of the following interests you? (Select all that apply)

Mediation

Collaborative Practice

I would like more information about both.

How Did You Hear About Us?

If referred by someone, who can we thank?

Final Details & Preferences

So we can make you feel at home when you visit us, what’s your preferred drink?

Tea

Coffee

Hot Chocolate

Water

Would you like to receive our legal updates via email?

Yes

Our initial consultation fee is our hourly rate (which varies depending on the lawyer). Do you agree?

Yes

No– I have a question about payment options

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