In order to help you we need to maintain a record of your case, which may contain sensitive personal data. The law says we must get your consent to do this. Everything you tell us will be treated confidentially. If you do not wish your information to be stored we will record your case as anonymous; this will mean if you come back to us for further help, we will be unable to locate your information. Sensitive personal data is defined as information relating to any of the following: racial or ethnic origin, political opinions, religious beliefs, trade union membership, health, sexuality or sex life, offences and/or convictions.
All fields marked with an asterisk (*) are required.