Client Details Questionnaire

If you require legal advice or representation please complete and submit the Client Details Questionnaire below. Alternatively, you can download the Questionnaire in PDF format which you can print, complete and send to our office by fax.

Personal Details Name first:

Name middle:

Name last:

Date of Birth:

Address:

Email:

Phone home:

Mobile Phone:

Work Phone:

Charges What are you charged with?:

Date of last Court appearance:

What happend at your last Court Appearance:

Which Court?:

Other issues requiring assistance:

How can I help?:

Authority to Access your Records and Information

If the matter is urgent and you think I may need to access your Police and Court records as a matter of urgency before we can arrange an appointment please enter a fax number in the space below. We will fax you a form authorising us to contact the Police and access your records on your behalf. Please sign the letter and fax it back to us.

Fax number for Authorisation Form:

Call now on 09 377 5889

Karen Harding

Criminal Lawyer

Client Details Questionnaire