Online Legal Clinic form Where you live: we can only assist people living, working or studying in Lambeth(required) Bishop's Brixton Hill Clapham Common Clapham Town Coldharbour Ferndale Gypsy Hill Herne Hill Knight's Hill Larkhall Oval Prince's St Leonards Stockwell Streatham Hill Streatham South Streatham Wells Thornton Thurlow Park Tulse Hill Vassall I confirm I have read and agree to the User Agreement: https://brixtonadvice.org.uk/online-legal-clinic/(required) I confirm I have read and agree to the privacy explanation at: https://brixtonadvice.org.uk/your-data-your-rights/ (required) Your full name(required) Email address(required) Re-enter your email(required) Telephone number (leave blank if you would prefer us to contact you in writing only) Please provide a summary of the legal issue that you need help with(required) Let us know if you have any special needs or disability we should be aware of when trying to contact you and if you have a preferred method of contact Please tell us how you found out about the Online Legal Clinic(required) The following questions help us see whether we are helping all the different sections of our community and can help us identify trends over time. This information is helpful to us but if you do not wish to answer any question select 'Prefer not to say' Choose one option that best describes your ethnic group or background(required) Please select White Mixed or Multiple ethnic groups Asian/Asian British Black/ African/Caribbean/Black British Other ethnic group Prefer not to say Please tell us your age group(required) Please select 16 - 24 25 - 44 45 - 64 65 - 74 75 or over Prefer not to say What best describes your gender(required) Please select Female Male Other Prefer not to say Please select any that apply(required) I do not have a disability I have a physical disability I have a long-term illness I have a mental health condition I have a sensory impairment Prefer not to say Your household(required) Please select I live alone I have others living with me Prefer not to say Please indicate which of the following best represents your current situation(required) Please select In full-time employment In full-time employment and furloughed from work In part-time employment In part-time employment and furloughed from work I am self-employed I am out of work and claiming benefits I am out of work and not claiming benefits I am retired Prefer not to say Which of the following best describes where you live(required) Please select Council property Housing Association property Privately rented Owned by me or the person I am staying with Provided by my employer In a care home or other type of managed property I am homeless Prefer not to say You can edit your answers above before you submit this form. When you have finished, please click the Submit button below. Please close this browser window after you have clicked Submit Submit Website Privacy Notice