Self Referral form


WE CAN ONLY ADVICE IN MATTERS OF FAMILY LAW. WE CANNOT PROVIDE ADVICE ON CRIMINAL LAW OR IMMIGRATION 

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 you 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
Enter your postcode and click "Find my address"










Please ensure you provide either a phone number or email




Our admin team needs to have an initial call with you in order to make sure we can match you with the most appropriate solicitor.  We make those calls between 10am and 4pm Monday to Friday.

*Please note that we will be able to arrange for your actual solicitor appointment within usual business hours



For example do you have any particular needs relating to vision, hearing or anything else that we should be mindful of?








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 you.   

Without this information we cannot progress your referral as will be unable to confirm we can find a solicitor that can talk with you.

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



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



Our solicitors also need to ensure there is no conflict of interest with any children involved so again  we require the details of the children please.   

Without this information we cannot progress your referral as will be unable to confirm we can find a solicitor that can talk with you.

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





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



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



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



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



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



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



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



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



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



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

















Confidentiality and information sharing agreement

FLAG DV is dedicated to providing a safe and supportive environment where you can share information with your support worker with confidence, knowing that we will treat it respectfully and confidentially, in line with GDPR requirements. We will only share your information with other agencies or services with your prior consent. However, if you tell us something that indicates that a vulnerable adult or child is at risk of harm, we are obligated to follow safeguarding procedures to ensure that the appropriate services are informed.


Safeguarding is something that we understand can be upsetting and, at times, scary. FLAG DV will work with you, wherever possible, to obtain your consent, keep you informed and support you throughout the process. There may be occasions when we may need to act without your consent, and in these circumstances, your support worker will do all that they can to support you through this process.


If you require more information on this you can ask your support worker to provide you with the FLAG DV safeguarding policies, safeguarding policy statements and information sharing procedures.


Right of access

You can ask to see your case file at any time. If you would like a copy of the information we hold about you, then you can make a subject access request in writing. These requests will then be handled in accordance with the FLAG DV Subject Access Request policy. 


So that we know you have read and understood this agreement, please answer yes or no to each statement. 


Please read these statements below and do not hit submit unless you understand and agree to the statements

  • I understand that information about me will be held confidentially unless I give my permission for it to be shared with others.
  • I understand that there are exceptions to this, and in the event that myself or anyone else is assessed to be at high risk of harm,
  • Information about me, and or the person at risk of harm, can be shared without my permission.
  • I understand that I have a right to access my information and the process requesting my information has been explained to me.