To enable us to assist you better, please provide a short introduction of yourself and what you require from the Clinic. We maintain strict confidentiality of all our patrons, and your responses to this form will not be shared with anyone.
Name?
Email Address?
Do you identify yourself with a marginalised community?
Preferred Language?
Our lawyers speak Hindi and English. We will require the services of a translator for consultation in other languages.
Do you work for any print/video media house? If yes, please provide its name.
(If working freelance/independent, please indicate where your bylines appear most often.)
Where do you live?
(You don't have to disclose your address. Just the district and state will suffice.)
Are you a member of any press union or media organisation? If yes, please provide its name.
Do you need urgent assisstance?
If yes, please provide your preferred date and time for consultation.
Please provide a short summary of the legal issue you need help with.
How did you hear about us?