Quick Application · Drink / Drug Drive

Take 2 minutes and answer as many of the questions as you can. As soon as I receive your response, I or one of my staff will contact you and make an appointment for you to see me the very next day.

Step 1 of 3

Personal Details

1.01 First name:

Your first name is required
1.02 Middle name:

Your middle name is required - if no middle name exists, leave blank
1.03 Last name:

Your last name is required
1.04 Date of birth:

Example: March 10, 1982

Contact

1.05 Email address:

A valid email address is required
1.06 Home Phone:

Example: 09 255 4242
1.07 Work Phone:

Example: 09 888 1234 ext. 789
1.08 Mobile:

Example: 021 123 1234

Address

1.09 I live at:

Example: 123 Evergreen Street
1.10 ... in the suburb of:

Example: Takapuna

Terms and Conditions of engagement are:

  1. Melanie Coxon holds no indemnity insurance.
  2. Melanie Coxon has had no Law Society complaints in her practising career.
  3. Melanie Coxon has her own complaints procedure available in accordance with the Client Care Rules 2008 of the Lawyers and Conveyancers Act 2006. Details supplied upon engagement, at request, or online here.

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Phone: 09-377-8440   Fax: 09 377 8454   Mobile: 021-9-111-33 or
021-9-111-55   Email: melanie@lawyerhelp.co.nz
Address: Lawyer Help, Cathedral House Level 5/48-52 Wyndham Street, Auckland CBD, Auckland 1010
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