Request for Legal Assistance Form - Rexdale Community Legal Clinic

1Contact Information

2Area of Law

3Income

4More Information

5Additional Optional Information

All of our legal services are confidential and any information provided on this form will be reviewed by legal clinic staff. Please note that calls from our office are often from a blocked number.

Please note that absolutely under no circumstances does submitting this Request for Legal Assistance form or any supporting documentation retain our services nor will we take any action on your behalf prior to meeting with you. Please note that we will contact you within two (2) business days from submitting this completed form to discuss your situation and determine if or how we can assist you. If your matter needs urgent attention, please contact us via telephone at 416-741-5201 x 1. Transmissions are not confidential. Rexdale Community Legal Clinic does not guarantee the confidentiality of the content of any email transmission facilitated by this website. If you wish to provide confidential information to us, contact us by phone.

Let’s first make sure we are your local clinic. Individuals living in our catchment have a postal code beginning with one of the following: M9V, M9W, M9P or M9R. If your postal code starts differently, please enter your postal code on Legal Aid Ontario's website to confirm the location of your local clinic. http://www.legalaid.on.ca/legal-clinics/

I have confirmed that RCLC is my local clinic? *

Contact Information

All questions with an asterisk (*) requires an answer.

Legal First & Last Name *

Preferred Name *

Your Pronouns

Phone Number *

Check if we can leave you a voice message at this number.

Alternate Phone Number

(copy)

Check if we can leave you a voice message at this number.

Check if we can contact you by email.

Your phone does not accept private calls or you prefer for us to not call from blocked number *

Is there a particular time that is good, or bad, for contacting you?

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Buzzer Code