Relationship and personal advice form

In order to get advice, please fill in the form below. Please complete ALL parts of the form. If a part of the form does not apply to you or you are unsure of an answer, you must still fill it in with "not applicable" or similar

Your Full Name:
Your Email Address:
Your Postal Address
A Contact Phone Number
Are you and your partner living together at present?
Are you and your partner married or in a civil partnership?
Has there been any violence?
Are you or your partner subject to immigration control?
Do both parties agree about what should happen?
Are there any dependant children living with you?
Are there any issues about where the children will live and/or their contact with your partner?
Does the family get any benefits?
Where do you and your partner's income come from e.g. working, benefits, tax credits, pensions?
Is your present home rented or do you have a mortgage?
Is the home in joint names or in one name? (whose?)
Are there any issues about who stays in the home?
Do you need to leave (or ask partner to leave) at short notice (e.g. because of violence)?
Are there things on joint credit?
Any there any other issues not asked about that you would like us to know?
Provide a description of the problem, what has led up to the situation, and what outcome is wanted.