Case Referral Form

Please provide the details in the form below for the case that is being referred to Blackstone Law Clinic.

Referring Organization

Please enter the name of the organization that is referring the case.

Name

Please enter the name of the client.

Phone Number

Enter the client`s phone number.

Email Address

Optional (Enter the email of the client.)

Type of Legal Matter

Family matter, Domestic Violence, Property Matter etc.

Short Description of the Legal Issue

Please enter a short description of the legal issue the client needs help with.