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Referral Form

Client Referral Form

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Is the client aware of referral and agreeable to it?
Service required: (Please tick the relevant boxes)
Name
Address
Ethnicity
Annual salary
Does the client have any Disabilities?
Please note: Referrals are that missing details of other parties, if applicable to the matter, will NOT be accepted.
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Pilbara Community Legal Service is accredited with the National Legal Scheme for Community Legal Centres

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Acknowledgement of Country

Pilbara Community Legal Service recognises the traditional owners of the lands across the Pilbara region and particularly the traditional owners on which the Pilbara Community Legal Service Offices are situated. We pay deep respect to Elders both past and present.  

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