Dads Unlimited
Submit a Case

Case Information
Department
Contact Name
Email
Subject
Description
Brief description of issues faced
Status
Home Address: House name or number and street name
Home address: Postcode
Legacy:Home Address
Can we add you to our mailing list?
How did you hear about Dads Unlimited?
Legacy: How you heard about us?
Where did you hear about Dads Unlimited?
Where did you hear about DU is other
Your current living arrangements
Employment status
Have you ever served in the Armed Forces/Reserves?
Have the Police and Social Services been involved?
Legacy:Police or Social Services involved?
Name of person filling out form if not Dad
Welfare
Have you had suicidal thoughts?
Legacy:Have you had suicidal thoughts?
Taken illegal drugs or abused alcohol?
Legacy:Taken illegal drugs or abused alcohol?
Have you been the victim of domestic abuse?
Did you report Domestic Abuse to the Police?
If you did not report DA to the Police - Why?
Have you been a victim of other crimes previously?
Children
Current child arrangements
How many children do you have?
Child 1 age?
Child 1 schools name?
Child 2 age?
Child 2 schools name?
Child 3 age?
Child 3 schools name?
Child 4 age?
Child 4 schools name?
Additional detail on children
Parental Responsibility?
Legacy: Age of Child 1
Legacy:Age of Child 2
Legacy:Age of Child 3
Legacy:Age of Child 4
Legacy: Name of schools
Legal
Any Convictions Cautions Warnings Reprimands?
Currently instructing solicitor or barrister
Have any Court proceedings already commenced?
Additional Information
Due Date
Priority
Channel
Word Verification
Attachment(s)
(Up to 20 MB)