Make a Referral - JustRight Scotland

Name *

Email *

Phone Number *

Address

I need help with (choose one or more) *

Gender-based violence or abuse (as a woman)

Immigration status or asylum claim

Trafficking or exploitation

Disability discrimination

Other discrimination or harassment

Other legal issue

Please give a short summary of why you need legal help (just 2-3 sentences) *

Do you need an interpreter (or another adjustment for us to communicate with you)?

Yes

What language or adjustment do you require?

If you helped someone else to complete this form, and would like us to contact you, or if you completed the form yourself but would like us to contact an organisation supporting you, please provide a contact name and details.

I helped someone else but please contact me

Please contact this organisation on my behalf

Thanks for making a referral to us. We will use the information you have provided to consider your request for help with legal advice, to reply to you and to keep a record of the referrals we receive. JustRight Scotland may use some of this information to monitor our work and contribute to research, but would only do so anonymously, so that you cannot be identified. We promise to keep your information, including your private and sensitive information, safe and secure. You can ask to see what information we hold about you at any time, and you can ask us to delete this information if you wish. For more information please see our Privacy Policy.

I confirm that I would like to make this referral to JustRight Scotland for help with legal advice. I understand that JustRight Scotland will use my information in the ways explained above.