Legal services – Requesting legal information or advice

Your Full Name (required)

Your Date of Birth

Below are the areas of law where we can help. We do not practice Family or Criminal Law - For family or criminal law advice, please see www.legalaid.on.ca.

Please check what you need help with (select all that apply)Consumer & DebtEmployment & WorkHousing (Tenant Rights)Human RightsIncome Assistance RightsSeniors' IssuesSexual Harassment at WorkVictims of CrimeWills & Powers of AttorneyOther

Name of your Landlord (only if you are calling about a TENANT problem)

Name of your Employer (only if you are calling about an EMPLOYMENT problem)

Your Email (required)

Your Phone Number

Please check if we can contact you by:Phone - OK to leave a voicemailPhone - but do NOT leave voicemailText MessageEmail

If contacting you by phone, do you need us to block our phone number? (Select one) (required)YesNo

Your Street Address (required)

Your City (required)

Your Postal Code (required)

What County do you live in? (Select from dropdown) (required)—Please choose an option—Hastings CountyPrince Edward CountyLennox & Addington CountyUnknownOther

Your Main Source of Income (Select from dropdown) (required)—Please choose an option—Ontario Works (OW)Ontario Disability Support (ODSP)Canada Pension Plan Disability (CPPD)CPP Retirement and/or OAS/GAINS)Employment IncomeWorkers' Compensation BenefitsOther

Tell us a bit about the problem (600 character limit).0

Your Gender Identity (Select from dropdown) (required)—Please choose an option—Prefer Not to AnswerMaleFemaleTransgendered MaleTransgendered FemaleTwo-SpiritedAgenderIntersex

Your Preferred Pronouns (Select from dropdown) (required)—Please choose an option—Prefer Not to Answerhe/himshe/herthey/themOther

If you picked "Other" Pronouns above, please specify here:

Your Language Spoken (optional)

Do you need an interpreter? (Select from dropdown) (optional)NoYes

If you picked "Yes" above, please specify the type of interpreter here:

Your Ethno-Racial Group (Select from dropdown) (required)—Please choose an option—Unknown/Choose not to identifyIndigenous (inside North America)Indigenous (outside North America)White/Caucasian (North American)White/Caucasian (Other)Latin AmericanAsian - South AsianAsian - Southwest AsianAsian - West AsianAsian - FilipinoAsian - ChineseAsian - KoreanAsian - JapaneseMiddle Eastern - ArabMiddle Eastern - OtherAfrican Ancestry - North AmericanAfrican Ancestry - CaribbeanAfrican Ancestry - Latin AmericanAfrican Ancestry - EuropeanAfrican Ancestry - Continental - North AfricaAfrican Ancestry - Continental - South AfricaAfrican Ancestry - Continental - East AfricaAfrican Ancestry - Continental - West AfricaAfrican Ancestry - Continental - SomaliOther or Mixed Racial Heritage

If you picked "Other" Ethno-Racial group above, please specify here:

Is there anything else we should know about you that would help us serve you better?

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