Separation Form

Relationship Status*

Currently Married

De Facto Relationship

Already Divorced

Other

Please describe your current relationship status.

Other Relationship Status*

We were married outside of Australia

We were married in a civil ceremony

We had a religious wedding, but I am not sure if it was valid

We did get married, but I don't think it was a proper marriage

Other

Which of these options best describes your relationship?

Note to legally end a defacto relationship, all you need to do is communicate your intention to end the relationship. Generally you have 2 years from the date of separation to bring proceedings to divide your assets and liabilities and seek maintenance.

What best describes your situation?*

In a relationship but thinking about separation

I think we are separating at the moment

We have separated and I am not sure what is next

We separated a while ago & I want to get things sorted

What is the nature of your relationship with your partner?*

We are getting along well

We are amicable

We are mostly amicable but it is shaky

I want to be amicable but things are hard

Things are pretty bad right now

I have concerns for my safety or the safety of other people

Your safety & that of your children is very important. If the situation is urgent, do not wait, contact 000. If the situation is not an emergency, we can reschedule an appointment to discuss your safety needs. In the meantime, please continue with this questionnaire.

Do you have children with your partner?*

Yes

I have children but am not looking for help with parenting at this stage

We have children but not with each other

Our children our over 18

We have an adopted child or children

I am not the biological parent but have raised my partners child / children as my own

What are the names of your children?*

What are the ages of your children?*

What best describes your financial situation?*

We have a fair amount of assets

We have some assets but not a lot

We don't really have any assets of value

I don't know

I don't want assistance with the financial side of the relationship at this point

Which of the following apply to you? Please tick any that apply:

I need help to deal with some issues while we work on long term solutions

We are having trouble agreeing on who will stay in the home & who will leave

I would like some help with how I should talk to my spouse

I would like some help with how I should talk to children

I am struggling emotionally and would like to speak to someone

I need help to make sure I am financially supported

I want to finalise this as quickly and painlessly as possible

We have been trying to resolve things but not I need a circuit breaker

I need an order to keep me safe

What is your partner's name?*

What is your partner's date of birth?*

What is your partner's residential address?*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What is your name?*

What is your date of birth?*

What is your residential address?*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What is your email address?*

Enter Email Confirm Email

What is your phone number?*

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