Online Request Form – Legal Entitlements and Problem-Solving (LEaP) Project

If you would like to ask for support from the Project, please read our Guidelines first and then complete the form below. If you have any questions, you can contact us at probono@cerebra.org.uk or on 01267 242582.

Please enter your area code and phone number without spaces

Your Child's Details

Please enter as dd/mm/yyyy e.g. 21/12/1956

Your Concerns

In order for us to process your request for a referral to the Legal Entitlements and Problem-Solving Project, we will store your details electronically and anonymised data may be used for research purposes connected to the Project. We respect your right to privacy and will keep safe any personal details that you give us in line with the UK Legislation on Data Protection. We will securely store the data you enter and only use it for the above purposes. We do not sell or share any information with third parties.

Please indicate that you are happy for us to store and process your information in this way. Without your consent we will be unable to proceed with your enquiry.