Agency referral form


Please note this appointment is an ADVICE legal appointment only. 

The free legal advice provided by FLAG DV is available only to people experiencing domestic abuse. Domestic abuse is defined as an incident or pattern of incidents of controlling, coercive, threatening, degrading and violent behaviour, including sexual violence, in the majority of cases by a partner or ex-partner, but also by a family member. 

Anyone forced to alter their behaviour because they are frightened of their partner’s reaction is being abused. 

Our service is for anyone who is experiencing domestic abuse, whether they have left the relationship or are still in it



Currently we are not able to accept referrals from other counties. You may find it useful to visit www.lawworks.org.uk as this is a charity who also offer free legal advice. Alternatively, the following services may be of assistance:
  • https://www.lawcentres.org.uk/i-am-looking-for-advice
  • otherwise your nearest Citizens Advice Bureau may be able to suggest additional local legal support.
If you are worried for your safety and in immediate danger, please phone 999. If you require the police but it is not an emergency, please ring 101. You may also wish to contact the National Domestic Abuse Helpline on 0808 2000 247.

Currently we are not able to accept referrals from people under 18.  You may find it useful to visit www.lawworks.org.uk as this is a charity who also offer free legal advice. Alternatively, the following services may be of assistance:
  • https://www.lawcentres.org.uk/i-am-looking-for-advice
  • otherwise your nearest Citizens Advice Bureau may be able to suggest additional local legal support.
If you are worried for your safety and in immediate danger, please phone 999. If you require the police but it is not an emergency, please ring 101. You may also wish to contact the National Domestic Abuse Helpline on 0808 2000 247.



















Please enter your date of birth in dd/mm/yyyy format
Please enter the Postcode where the client is statying and click "Find my address"























In order for our solicitors to provide legal advice they are required to confirm that there is no conflict of interest in doing so.

For this we require the details of the person who has been abusing your client and the details of any children.   

This information will not be used in any way other than to be able to progress their referral with Flag DV 

Please consider providing this information now so as to reduce admin time and facilitate us being able to see your client as quickly as possible.  If you cannot provide the information now then we will be required to ask your client for this information before we will be able to progress their referral


Please enter their date of birth in dd/mm/yyyy format








Please enter their DOB in dd/mm/yyyy format



Please enter their DOB in dd/mm/yyyy format



Please enter their DOB in dd/mm/yyyy format



Please enter their DOB in dd/mm/yyyy format



Please enter their DOB in dd/mm/yyyy format



Please enter their DOB in dd/mm/yyyy format



Please enter their DOB in dd/mm/yyyy format



Please enter their DOB in dd/mm/yyyy format



Please enter their DOB in dd/mm/yyyy format



Please enter their DOB in dd/mm/yyyy format















Please note we may be in touch for further information to determine eligibility and that we cannot guarantee the support








Your privacy is important to us and we will process your personal data in accordance with data protection laws. Click here to read our how our Privacy Notice sets out how we process personal data about you and other individuals about whom you might disclose information.