Tenancy Form

MACKAY REGIONAL COMMUNITY LEGAL CENTRE (MRCLC)
CONFIDENTIAL CLIENT ADVICE FORM – TENANCY

Personal Details (Name and contact details remain confidential to MRCLC)

If another person accompanies you in your appointment you may be waiving client legal privilege.

Statistical Details: (We must ask the following questions, but you do not have to answer them)

(your answer does not affect your eligibility for our service in any way)
(if not born in Australia)

Proficiency in English:

(if applicable)
(all)

Tenancy Law Issues/Legal Matter:

S/F
S/F
S/F
S/F
(E.g., house, unit, room in house, caravan etc)
(E.g., private, government, other)
(start to end dates, if known)

If phone, solicitor or co-ordinator to read to client.

I confirm the above information is true and correct. I authorise the MRCLC to destroy this advice form and any other documents or letters, including all contents of my client file in this matter that are in the MRCLC’s possession from 7 years after (a) the date of this advice or, if applicable, (b) the end of any casework they perform in this matter. I consent to my de-identified information (that is, not using my real name) being used by the MRCLC in their reports to funding bodies, funding submissions or any other way they consider appropriate, I consent to MRCLC reporting to Tenants Queensland that my referral was actioned and of any relevant outcomes.

The information you provide will not be shown to people outside of Centre staff and volunteers unless you give permission or as required by law, other than where it is necessary to comply with the requirements of our professional indemnity insurance cover and/or our national Community Legal Centre accreditation scheme requirements. I have read and understand the Client Charter or been offered the opportunity to read the Client Charter, if appointment is by phone.

Contact type

REFERRALS

If referred to MRCLC – client is to ring and book another appointment. Simple / Facilitated referral?

STOP

Must state Yes, No, N/A or Expired