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Call 08 8009 9321 Email support@warrawarra.org.au

Online Intake Form

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Online Intake Form

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08 8009 9321
support@warrawarra.org.au
184/186 Argent St, Broken Hill NSW 2880
PO BOX 597 Broken Hill, NSW 2880

Opening Hours

Monday 9:00 AM to 5:00 PM

Tuesday 9:00 AM to 5:00 PM

Wednesday 9:00 AM to 5:00 PM

Thursday 9:00 AM to 5:00 PM

Friday 9:00 AM to 5:00 PM

Saturday Closed

Sunday Closed

We have created an online version of our Intake Form for convenience.

Feel free to fill and submit the form if you are seeking legal or non-legal assistance.

Thank you for completing this form. We will endeavour to get back to you within 24-48 business hours.

Online Intake Form

Please enable JavaScript in your browser to complete this form.

1. What is your Full Name Inclusive of middle names *

2. Have you ever been known by any other names

3. What is your Date of Birth *

Example: 12/02/1978

your Name involved

4. What is your address *

5. What is your Cultural Identity

Aboriginal
Torres Strait Islander
Both Aboriginal and Torres Strait Islander
Neither Aboriginal andor Torres Strait Islander

6. Can you provide a Confirmation of Aboriginality Certificate

Yes
No

7. What is your best Contact Number *

8. What is your email address *

Email

Confirm Email

9. In what matter are you requiring assistance

Family Law
Domestic Violence
Child Protection
Victims Assistance
Counselling

10. Please provide a brief overview of your issue needing assistance

11. If there is another party involved please provide their Full Name Date of Birth and Address If known

12. If there are Children involved in your matter please provide their Full Names and Dates of Birth

Find our Office Location

Find out more about our Outreach Service

Get In Touch

Contact us for enquiries, complaints and feedback

PO BOX 597 Broken Hill, NSW 2880

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Client Service Charter

©2024. Warra Warra Legal Service All Rights Reserved.

Warra Warra Legal Service honours the traditional custodians of the lands on which we live and operate. We acknowledge their ongoing connection to the land, water, and culture, and we pay tribute to their Elders, both past and present.

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