{"id":42947,"date":"2024-09-13T14:24:22","date_gmt":"2024-09-13T18:24:22","guid":{"rendered":"https:\/\/www.barreaudemontreal.qc.ca\/public\/services-au-public-en\/need-a-lawyer\/service-de-reference-formulaire-de-demande-pour-une-reference\/"},"modified":"2025-08-13T10:59:08","modified_gmt":"2025-08-13T14:59:08","slug":"referral-service-referral-request-form","status":"publish","type":"page","link":"https:\/\/www.barreaudemontreal.qc.ca\/en\/public\/services-au-public-en\/need-a-lawyer\/referral-service-referral-request-form\/","title":{"rendered":"Referral Service\u00a0\u2013\u00a0Referral Request Form"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_55' style='display:none'>\n                        <div class='gform_heading'>\n                            <p class='gform_description'><p><br>The Referral Service provides anyone who requests it and who can afford the costs (or qualifies for Legal Aid) with the name of a lawyer voluntarily registered with the service and willing to offer an initial one-hour consultation for a fee of $60 plus taxes, if applicable.<\/br>\r\n\r\n<br><strong>This is not a representation service<\/strong> : only the lawyer will know whether they can offer you a consultation and when they\u2019re available. If the lawyer is unable to help you, we can refer you to another. <\/br>\r\n\r\n<br><strong>Only one form<\/strong> will be processed per file: additional referral requests must be submitted by e-mail only. <\/br>\r\n\r\n<br><strong>You will receive an email with a copy of your form as submitted.<\/strong>\r\n\r\n<\/br>\r\n<br><\/br><\/p><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_55'  action='\/en\/wp-json\/wp\/v2\/pages\/42947' data-formid='55' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_55' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_55_24\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">YOUR INFORMATION<\/h3><\/div><fieldset id=\"field_55_22\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name (name of the person completing the form, not the name of an organization, company or business)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_55_22'>\n                            \n                            <span id='input_55_22_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_55_22_3' class='gform-field-label gform-field-label--type-sub '>First name<\/label>\n                                                    <input type='text' name='input_22.3' id='input_55_22_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_55_22_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_55_22_6' class='gform-field-label gform-field-label--type-sub '>Last name<\/label>\n                                                            <input type='text' name='input_22.6' id='input_55_22_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_55_23\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_55_23'>Postal code \/ City or borough<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_55_23' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_55_54\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_55_54'>Telephone number<\/label><div class='ginput_container ginput_container_text'><input name='input_54' id='input_55_54' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_55_19\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >E-mail address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_55_19_container'>\n                                <span id='input_55_19_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_19' id='input_55_19' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_55_19' class='gform-field-label gform-field-label--type-sub '>Enter your E-mail<\/label>\n                                <\/span>\n                                <span id='input_55_19_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_19_2' id='input_55_19_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_55_19_2' class='gform-field-label gform-field-label--type-sub '>Confirm your E-mail<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><div id=\"field_55_25\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">YOUR NEEDS<\/h3><\/div><fieldset id=\"field_55_10\" class=\"gfield gfield--type-post_custom_field gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Language(s)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_10'><div class='gchoice gchoice_55_10_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.1' type='checkbox'  value='French'  id='choice_55_10_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_10_1' id='label_55_10_1' class='gform-field-label gform-field-label--type-inline'>French<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_10_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.2' type='checkbox'  value='English'  id='choice_55_10_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_10_2' id='label_55_10_2' class='gform-field-label gform-field-label--type-inline'>English<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_10_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.3' type='checkbox'  value='Other (if the preferred language is not on the list, please indicate it under \u201cAdditional information\/Brief summary of your situation\u201d below)'  id='choice_55_10_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_10_3' id='label_55_10_3' class='gform-field-label gform-field-label--type-inline'>Other (if the preferred language is not on the list, please indicate it under \u201cAdditional information\/Brief summary of your situation\u201d below)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_28\" class=\"gfield gfield--type-post_custom_field gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Legal Aid mandate<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_55_28'>\n\t\t\t<div class='gchoice gchoice_55_28_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='Yes: my case is approved by Legal Aid Services who will pay my legal fees'  id='choice_55_28_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_55_28_0' id='label_55_28_0' class='gform-field-label gform-field-label--type-inline'>Yes: my case is approved by Legal Aid Services who will pay my legal fees<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_55_28_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='No'  id='choice_55_28_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_55_28_1' id='label_55_28_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_73\" class=\"gfield gfield--type-post_custom_field gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Services or accommodations desired at the lawyer\u2019s office<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_73'><div class='gchoice gchoice_55_73_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.1' type='checkbox'  value='Accessible for people with reduced mobility'  id='choice_55_73_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_73_1' id='label_55_73_1' class='gform-field-label gform-field-label--type-inline'>Accessible for people with reduced mobility<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_73_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.2' type='checkbox'  value='Home service'  id='choice_55_73_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_73_2' id='label_55_73_2' class='gform-field-label gform-field-label--type-inline'>Home service<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_55_78\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">NATURE OF YOUR REQUEST<\/h3><\/div><fieldset id=\"field_55_107\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >AREAS OF LAW<\/legend><div class='gfield_description' id='gfield_description_55_107'><strong>Check the relevant areas of practice. If you are unsure which ones apply, leave them blank and explain your need below under \u201cAdditional information\/Brief summary of your situation\u201d<\/strong>\n<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_107'><div class='gchoice gchoice_55_107_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_107.1' type='checkbox'  value='Not sure which fields to select.'  id='choice_55_107_1'   aria-describedby=\"gfield_description_55_107\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_55_107_1' id='label_55_107_1' class='gform-field-label gform-field-label--type-inline'>Not sure which fields to select.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_61\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Administrative (SAAQ, employment insurance, Quebec Pension Plan)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_61'><div class='gchoice gchoice_55_61_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.1' type='checkbox'  value='Access to information'  id='choice_55_61_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_61_1' id='label_55_61_1' class='gform-field-label gform-field-label--type-inline'>Access to information<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_61_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.2' type='checkbox'  value='Employment insurance'  id='choice_55_61_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_61_2' id='label_55_61_2' class='gform-field-label gform-field-label--type-inline'>Employment insurance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_61_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.3' type='checkbox'  value='Municipal law'  id='choice_55_61_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_61_3' id='label_55_61_3' class='gform-field-label gform-field-label--type-inline'>Municipal law<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_61_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.4' type='checkbox'  value='Education (specify below)'  id='choice_55_61_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_61_4' id='label_55_61_4' class='gform-field-label gform-field-label--type-inline'>Education (specify below)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_61_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.5' type='checkbox'  value='Income support (welfare)'  id='choice_55_61_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_61_5' id='label_55_61_5' class='gform-field-label gform-field-label--type-inline'>Income support (welfare)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_61_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.6' type='checkbox'  value='Quebec automobile insurance (SAAQ) \u2013 Accident'  id='choice_55_61_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_61_6' id='label_55_61_6' class='gform-field-label gform-field-label--type-inline'>Quebec automobile insurance (SAAQ) \u2013 Accident<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_61_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.7' type='checkbox'  value='Quebec automobile insurance (SAAQ) \u2013 Licence'  id='choice_55_61_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_61_7' id='label_55_61_7' class='gform-field-label gform-field-label--type-inline'>Quebec automobile insurance (SAAQ) \u2013 Licence<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_55_94\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_55_94'>Education &#8211; Specify below<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_55_94'>(services needed by an elementary school student, exclusion from a university program, etc.)<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_94' id='input_55_94' class='textarea small'  aria-describedby=\"gfield_description_55_94\" maxlength='100'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_55_63\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Business<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_63'><div class='gchoice gchoice_55_63_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.1' type='checkbox'  value='Commercial (commercial leases, etc.)'  id='choice_55_63_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_63_1' id='label_55_63_1' class='gform-field-label gform-field-label--type-inline'>Commercial (commercial leases, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_63_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.2' type='checkbox'  value='Cooperatives'  id='choice_55_63_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_63_2' id='label_55_63_2' class='gform-field-label gform-field-label--type-inline'>Cooperatives<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_63_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.3' type='checkbox'  value='Non-profit organization'  id='choice_55_63_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_63_3' id='label_55_63_3' class='gform-field-label gform-field-label--type-inline'>Non-profit organization<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_63_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.4' type='checkbox'  value='Corporate (partnerships, companies)'  id='choice_55_63_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_63_4' id='label_55_63_4' class='gform-field-label gform-field-label--type-inline'>Corporate (partnerships, companies)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_63_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_63.5' type='checkbox'  value='Support for entrepreneurs'  id='choice_55_63_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_63_5' id='label_55_63_5' class='gform-field-label gform-field-label--type-inline'>Support for entrepreneurs<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_62\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Civil<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_62'><div class='gchoice gchoice_55_62_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.1' type='checkbox'  value='Insurance (specify below)'  id='choice_55_62_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_62_1' id='label_55_62_1' class='gform-field-label gform-field-label--type-inline'>Insurance (specify below)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_62_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.2' type='checkbox'  value='Consumer protection (specify below)'  id='choice_55_62_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_62_2' id='label_55_62_2' class='gform-field-label gform-field-label--type-inline'>Consumer protection (specify below)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_62_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.3' type='checkbox'  value='Estates\/successions'  id='choice_55_62_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_62_3' id='label_55_62_3' class='gform-field-label gform-field-label--type-inline'>Estates\/successions<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_62_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.4' type='checkbox'  value='Bankruptcy and insolvency (specify below)'  id='choice_55_62_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_62_4' id='label_55_62_4' class='gform-field-label gform-field-label--type-inline'>Bankruptcy and insolvency (specify below)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_62_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.5' type='checkbox'  value='Obligations\/contracts (loan between individuals, cancelling a contract, etc.)'  id='choice_55_62_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_62_5' id='label_55_62_5' class='gform-field-label gform-field-label--type-inline'>Obligations\/contracts (loan between individuals, cancelling a contract, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_55_98\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_55_98'>Consumer protection &#8211; Specify below<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_55_98'>(car loan or lease, credit card debt, defective goods, etc.)<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_98' id='input_55_98' class='textarea small'  aria-describedby=\"gfield_description_55_98\" maxlength='100'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_55_99\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_55_99'>Insurance &#8211; Specify below<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_55_99'>(group disability insurance related to my job, insurance linked to a building mortgage, loss of property due to theft or other incident, etc.)<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_99' id='input_55_99' class='textarea small'  aria-describedby=\"gfield_description_55_99\" maxlength='100'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_55_100\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_55_100'>Bankruptcy and insolvency &#8211; Specify below<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_55_100'>(regarding personal debts, corporate or business debts, etc.)<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_100' id='input_55_100' class='textarea small'  aria-describedby=\"gfield_description_55_100\" maxlength='100'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_55_56\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Criminal<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_56'><div class='gchoice gchoice_55_56_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.1' type='checkbox'  value='General Criminal Code (threats, assault, etc.)'  id='choice_55_56_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_56_1' id='label_55_56_1' class='gform-field-label gform-field-label--type-inline'>General Criminal Code (threats, assault, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_56_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.2' type='checkbox'  value='Prison law'  id='choice_55_56_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_56_2' id='label_55_56_2' class='gform-field-label gform-field-label--type-inline'>Prison law<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_56_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.3' type='checkbox'  value='Sexual offences'  id='choice_55_56_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_56_3' id='label_55_56_3' class='gform-field-label gform-field-label--type-inline'>Sexual offences<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_56_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.4' type='checkbox'  value='Economic crime (fraud, identity theft, etc.)'  id='choice_55_56_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_56_4' id='label_55_56_4' class='gform-field-label gform-field-label--type-inline'>Economic crime (fraud, identity theft, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_56_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.5' type='checkbox'  value='Impaired driving'  id='choice_55_56_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_56_5' id='label_55_56_5' class='gform-field-label gform-field-label--type-inline'>Impaired driving<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_60\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Disciplinary<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_60'><div class='gchoice gchoice_55_60_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_60.1' type='checkbox'  value='Disciplinary \u2013 plaintiff'  id='choice_55_60_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_60_1' id='label_55_60_1' class='gform-field-label gform-field-label--type-inline'>Disciplinary \u2013 plaintiff<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_60_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_60.2' type='checkbox'  value='Disciplinary \u2013 defendant'  id='choice_55_60_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_60_2' id='label_55_60_2' class='gform-field-label gform-field-label--type-inline'>Disciplinary \u2013 defendant<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_64\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Family \/ Youth \/ the Elderly<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_64'><div class='gchoice gchoice_55_64_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_64.1' type='checkbox'  value='Adoption'  id='choice_55_64_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_64_1' id='label_55_64_1' class='gform-field-label gform-field-label--type-inline'>Adoption<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_64_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_64.2' type='checkbox'  value='Filiation (name of a parent missing from birth certificate)'  id='choice_55_64_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_64_2' id='label_55_64_2' class='gform-field-label gform-field-label--type-inline'>Filiation (name of a parent missing from birth certificate)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_64_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_64.3' type='checkbox'  value='Common-law spouse'  id='choice_55_64_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_64_3' id='label_55_64_3' class='gform-field-label gform-field-label--type-inline'>Common-law spouse<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_64_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_64.4' type='checkbox'  value='Family (divorce, custody, child support)'  id='choice_55_64_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_64_4' id='label_55_64_4' class='gform-field-label gform-field-label--type-inline'>Family (divorce, custody, child support)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_64_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_64.5' type='checkbox'  value='Child\u2019s advocate'  id='choice_55_64_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_64_5' id='label_55_64_5' class='gform-field-label gform-field-label--type-inline'>Child\u2019s advocate<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_64_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_64.6' type='checkbox'  value='Young offenders (criminal and penal)'  id='choice_55_64_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_64_6' id='label_55_64_6' class='gform-field-label gform-field-label--type-inline'>Young offenders (criminal and penal)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_64_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_64.7' type='checkbox'  value='Youth protection (DPJ)'  id='choice_55_64_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_64_7' id='label_55_64_7' class='gform-field-label gform-field-label--type-inline'>Youth protection (DPJ)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_64_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_64.8' type='checkbox'  value='Elder law'  id='choice_55_64_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_64_8' id='label_55_64_8' class='gform-field-label gform-field-label--type-inline'>Elder law<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_66\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Tax<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_66'><div class='gchoice gchoice_55_66_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_66.1' type='checkbox'  value='Taxes, deductions and benefits'  id='choice_55_66_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_66_1' id='label_55_66_1' class='gform-field-label gform-field-label--type-inline'>Taxes, deductions and benefits<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_66_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_66.2' type='checkbox'  value='GST and QST'  id='choice_55_66_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_66_2' id='label_55_66_2' class='gform-field-label gform-field-label--type-inline'>GST and QST<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_66_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_66.3' type='checkbox'  value='Customs and excise'  id='choice_55_66_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_66_3' id='label_55_66_3' class='gform-field-label gform-field-label--type-inline'>Customs and excise<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_66_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_66.4' type='checkbox'  value='Tax offences \/ Fiscal offences'  id='choice_55_66_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_66_4' id='label_55_66_4' class='gform-field-label gform-field-label--type-inline'>Tax offences \/ Fiscal offences<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_66_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_66.5' type='checkbox'  value='Child benefits (family allowance, etc.)'  id='choice_55_66_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_66_5' id='label_55_66_5' class='gform-field-label gform-field-label--type-inline'>Child benefits (family allowance, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_65\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Immigration<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_65'><div class='gchoice gchoice_55_65_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_65.1' type='checkbox'  value='Citizenship'  id='choice_55_65_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_65_1' id='label_55_65_1' class='gform-field-label gform-field-label--type-inline'>Citizenship<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_65_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_65.2' type='checkbox'  value='Permanent residence\/sponsorship'  id='choice_55_65_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_65_2' id='label_55_65_2' class='gform-field-label gform-field-label--type-inline'>Permanent residence\/sponsorship<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_65_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_65.3' type='checkbox'  value='Refugee status (IRB)'  id='choice_55_65_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_65_3' id='label_55_65_3' class='gform-field-label gform-field-label--type-inline'>Refugee status (IRB)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_65_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_65.4' type='checkbox'  value='Temporary stay Temporary residence in Canada (visitor, work permit, etc.)'  id='choice_55_65_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_65_4' id='label_55_65_4' class='gform-field-label gform-field-label--type-inline'>Temporary stay Temporary residence in Canada (visitor, work permit, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_67\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Real estate<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_67'><div class='gchoice gchoice_55_67_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.1' type='checkbox'  value='Co-ownership (specify below)'  id='choice_55_67_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_67_1' id='label_55_67_1' class='gform-field-label gform-field-label--type-inline'>Co-ownership (specify below)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_67_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.2' type='checkbox'  value='Real estate brokerage'  id='choice_55_67_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_67_2' id='label_55_67_2' class='gform-field-label gform-field-label--type-inline'>Real estate brokerage<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_67_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.3' type='checkbox'  value='Latent \/hidden defects \u2013 plaintiff'  id='choice_55_67_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_67_3' id='label_55_67_3' class='gform-field-label gform-field-label--type-inline'>Latent \/hidden defects \u2013 plaintiff<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_67_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.4' type='checkbox'  value='Latent \/hidden defects \u2013 defendant'  id='choice_55_67_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_67_4' id='label_55_67_4' class='gform-field-label gform-field-label--type-inline'>Latent \/hidden defects \u2013 defendant<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_67_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_67.5' type='checkbox'  value='Financing and hypothecary recourses (mortgages)'  id='choice_55_67_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_67_5' id='label_55_67_5' class='gform-field-label gform-field-label--type-inline'>Financing and hypothecary recourses (mortgages)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_55_101\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_55_101'>Co-ownership (specify below)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_55_101'>(sharing \/ partition of a building owned by two individuals, questions about condominiums, etc.)<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_101' id='input_55_101' class='textarea small'  aria-describedby=\"gfield_description_55_101\" maxlength='100'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_55_55\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Housing<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_55'><div class='gchoice gchoice_55_55_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.1' type='checkbox'  value='Housing \u2013 tenant'  id='choice_55_55_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_55_1' id='label_55_55_1' class='gform-field-label gform-field-label--type-inline'>Housing \u2013 tenant<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_55_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.2' type='checkbox'  value='Housing \u2013 landlord \/ owner'  id='choice_55_55_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_55_2' id='label_55_55_2' class='gform-field-label gform-field-label--type-inline'>Housing \u2013 landlord \/ owner<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_55_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.3' type='checkbox'  value='Low-cost housing'  id='choice_55_55_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_55_3' id='label_55_55_3' class='gform-field-label gform-field-label--type-inline'>Low-cost housing<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_55_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.4' type='checkbox'  value='Housing cooperative'  id='choice_55_55_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_55_4' id='label_55_55_4' class='gform-field-label gform-field-label--type-inline'>Housing cooperative<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_57\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Penal<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_57'><div class='gchoice gchoice_55_57_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.1' type='checkbox'  value='Highway Safety Code'  id='choice_55_57_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_57_1' id='label_55_57_1' class='gform-field-label gform-field-label--type-inline'>Highway Safety Code<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_57_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.2' type='checkbox'  value='Provincial penal (AirBnB, Quebec electoral law, etc.)'  id='choice_55_57_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_57_2' id='label_55_57_2' class='gform-field-label gform-field-label--type-inline'>Provincial penal (AirBnB, Quebec electoral law, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_57_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.3' type='checkbox'  value='Federal penal (Can. electoral law, quarantine, etc.)'  id='choice_55_57_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_57_3' id='label_55_57_3' class='gform-field-label gform-field-label--type-inline'>Federal penal (Can. electoral law, quarantine, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_57_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.4' type='checkbox'  value='Municipal penal (noise offences, etc.)'  id='choice_55_57_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_57_4' id='label_55_57_4' class='gform-field-label gform-field-label--type-inline'>Municipal penal (noise offences, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_68\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Persons<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_68'><div class='gchoice gchoice_55_68_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_68.1' type='checkbox'  value='Protection regimes (tutorship, curatorship)'  id='choice_55_68_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_68_1' id='label_55_68_1' class='gform-field-label gform-field-label--type-inline'>Protection regimes (tutorship, curatorship)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_68_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_68.2' type='checkbox'  value='Protection mandate (mandate in case of incapacity)'  id='choice_55_68_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_68_2' id='label_55_68_2' class='gform-field-label gform-field-label--type-inline'>Protection mandate (mandate in case of incapacity)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_68_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_68.3' type='checkbox'  value='Refusal of care \/ treatment (specify below)'  id='choice_55_68_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_68_3' id='label_55_68_3' class='gform-field-label gform-field-label--type-inline'>Refusal of care \/ treatment (specify below)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_55_106\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_55_106'>Refusal of care \/ treatment (specify below)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_55_106'>(mental health or physical health)<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_106' id='input_55_106' class='textarea small'  aria-describedby=\"gfield_description_55_106\" maxlength='100'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_55_69\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Intellectual property<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_69'><div class='gchoice gchoice_55_69_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_69.1' type='checkbox'  value='Copyright'  id='choice_55_69_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_69_1' id='label_55_69_1' class='gform-field-label gform-field-label--type-inline'>Copyright<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_69_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_69.2' type='checkbox'  value='Trademarks'  id='choice_55_69_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_69_2' id='label_55_69_2' class='gform-field-label gform-field-label--type-inline'>Trademarks<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_69_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_69.3' type='checkbox'  value='Patents'  id='choice_55_69_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_69_3' id='label_55_69_3' class='gform-field-label gform-field-label--type-inline'>Patents<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_36\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Liability<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_36'><div class='gchoice gchoice_55_36_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.1' type='checkbox'  value='Civil liability'  id='choice_55_36_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_36_1' id='label_55_36_1' class='gform-field-label gform-field-label--type-inline'>Civil liability<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_36_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.2' type='checkbox'  value='Medical professional liability'  id='choice_55_36_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_36_2' id='label_55_36_2' class='gform-field-label gform-field-label--type-inline'>Medical professional liability<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_36_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.3' type='checkbox'  value='Lawyer\u2019s professional liability \u2013 plaintiff'  id='choice_55_36_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_36_3' id='label_55_36_3' class='gform-field-label gform-field-label--type-inline'>Lawyer\u2019s professional liability \u2013 plaintiff<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_36_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.4' type='checkbox'  value='Police professional liability'  id='choice_55_36_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_36_4' id='label_55_36_4' class='gform-field-label gform-field-label--type-inline'>Police professional liability<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_36_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.5' type='checkbox'  value='Other professional liability'  id='choice_55_36_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_36_5' id='label_55_36_5' class='gform-field-label gform-field-label--type-inline'>Other professional liability<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_59\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Labour<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_59'><div class='gchoice gchoice_55_59_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.1' type='checkbox'  value='Employer'  id='choice_55_59_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_59_1' id='label_55_59_1' class='gform-field-label gform-field-label--type-inline'>Employer<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_59_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.2' type='checkbox'  value='Employees-provincial (specify below)'  id='choice_55_59_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_59_2' id='label_55_59_2' class='gform-field-label gform-field-label--type-inline'>Employees-provincial (specify below)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_59_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.3' type='checkbox'  value='Employees-federal (specify below)'  id='choice_55_59_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_59_3' id='label_55_59_3' class='gform-field-label gform-field-label--type-inline'>Employees-federal (specify below)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_59_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.4' type='checkbox'  value='Unionized employees'  id='choice_55_59_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_59_4' id='label_55_59_4' class='gform-field-label gform-field-label--type-inline'>Unionized employees<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_59_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.5' type='checkbox'  value='Labour standards (CNESST)'  id='choice_55_59_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_59_5' id='label_55_59_5' class='gform-field-label gform-field-label--type-inline'>Labour standards (CNESST)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_59_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.6' type='checkbox'  value='Work-related accident (CNESST)'  id='choice_55_59_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_59_6' id='label_55_59_6' class='gform-field-label gform-field-label--type-inline'>Work-related accident (CNESST)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_55_103\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_55_103'>Employees-provincial (specify below)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_55_103'>(the employer&#8217;s sphere of activity: transportation within Quebec, medical care, provincial civil service, etc.)<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_103' id='input_55_103' class='textarea small'  aria-describedby=\"gfield_description_55_103\" maxlength='100'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_55_102\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_55_102'>Employees-federal (specify below)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_55_102'>(the employer&#8217;s sphere of activity: transportation across provinces, aeronautics, federal public service, etc.)<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_102' id='input_55_102' class='textarea small'  aria-describedby=\"gfield_description_55_102\" maxlength='100'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_55_58\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Victims of crime<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_58'><div class='gchoice gchoice_55_58_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.1' type='checkbox'  value='Benefits \/ Compensation (IVAC)'  id='choice_55_58_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_58_1' id='label_55_58_1' class='gform-field-label gform-field-label--type-inline'>Benefits \/ Compensation (IVAC)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_55_58_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.2' type='checkbox'  value='Victim support (guidance, filing a complaint, etc.)'  id='choice_55_58_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_58_2' id='label_55_58_2' class='gform-field-label gform-field-label--type-inline'>Victim support (guidance, filing a complaint, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_51\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Other<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_51'><div class='gchoice gchoice_55_51_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.1' type='checkbox'  value='The subject you are looking for is not listed above.'  id='choice_55_51_1'   aria-describedby=\"gfield_description_55_51\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_55_51_1' id='label_55_51_1' class='gform-field-label gform-field-label--type-inline'>The subject you are looking for is not listed above.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_55_51'>Please provide details about your request below under \u201cAdditional information\/Brief summary of your situation\u201d.<\/div><\/fieldset><div id=\"field_55_80\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_55_80'>ADDITIONAL INFORMATION\/BRIEF SUMMARY OF YOUR SITUATION<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_55_80'>Provide relevant details about your request (1,200 characters). (I\u2019m looking for a lawyer who speaks Persian, I want to contest a decision by the Tribunal du logement\/the Commission d\u2019acc\u00e8s \u00e0 l\u2019information, the IRB denied my asylum application, I want to enforce a judgement, etc.).<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_80' id='input_55_80' class='textarea large'  aria-describedby=\"gfield_description_55_80\" maxlength='1200'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_55_81\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_55_81'>LAWYER FOR THE OPPOSING PARTY<\/label><div class='gfield_description' id='gfield_description_55_81'>Since the lawyer referred to you will receive your name and be informed of your request, please provide us with the first and last name of the opposing party&#8217;s lawyer so we may avoid referring you to anyone who works at the same address as them.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_81' id='input_55_81' class='textarea small'  aria-describedby=\"gfield_description_55_81\" maxlength='150'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_55_85\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">ATTESTATIONS AND CONSENTS<\/h3><\/div><fieldset id=\"field_55_82\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >By checking this box:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_82'><div class='gchoice gchoice_55_82_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.1' type='checkbox'  value='I confirm that I am the person whose name is identified on this form and the user of the e-mail address and telephone number(s) provided.'  id='choice_55_82_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_82_1' id='label_55_82_1' class='gform-field-label gform-field-label--type-inline'>I confirm that I am the person whose name is identified on this form and the user of the e-mail address and telephone number(s) provided.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_86\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >By checking this box:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_86'><div class='gchoice gchoice_55_86_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_86.1' type='checkbox'  value='I confirm that I am 14 years of age or older.'  id='choice_55_86_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_86_1' id='label_55_86_1' class='gform-field-label gform-field-label--type-inline'>I confirm that I am 14 years of age or older.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_87\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >By checking this box:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_87'><div class='gchoice gchoice_55_87_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_87.1' type='checkbox'  value='I confirm that I have read and understood the &lt;a href=&quot;https:\/\/www.barreaudemontreal.qc.ca\/wp-content\/uploads\/administrative-rules-referral-service-for-individuals.pdf&quot; target=&quot;_blank&quot; rel=&quot;noreferrer noopener&quot;&gt;administrative rules&lt;\/a&gt; of the Barreau de Montr\u00e9al\u2019s Referral Service and I accept them.'  id='choice_55_87_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_87_1' id='label_55_87_1' class='gform-field-label gform-field-label--type-inline'>I confirm that I have read and understood the <a href=\"https:\/\/www.barreaudemontreal.qc.ca\/wp-content\/uploads\/administrative-rules-referral-service-for-individuals.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">administrative rules<\/a> of the Barreau de Montr\u00e9al\u2019s Referral Service and I accept them.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_89\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >By checking this box:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_89'><div class='gchoice gchoice_55_89_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_89.1' type='checkbox'  value='I confirm that I have read and understood the &lt;a href=&quot;https:\/\/www.barreaudemontreal.qc.ca\/wp-content\/uploads\/privacypolicy.pdf&quot; target=&quot;_blank&quot; rel=&quot;noreferrer noopener&quot;&gt;Barreau de Montr\u00e9al&#039;s privacy policy&lt;\/a&gt;, in particular regarding the purposes for which my personal information is collected, access to and correction of my personal information as well as the withdrawal of my consent, and I accept it.'  id='choice_55_89_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_89_1' id='label_55_89_1' class='gform-field-label gform-field-label--type-inline'>I confirm that I have read and understood the <a href=\"https:\/\/www.barreaudemontreal.qc.ca\/wp-content\/uploads\/privacypolicy.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Barreau de Montr\u00e9al&#8217;s privacy policy<\/a>, in particular regarding the purposes for which my personal information is collected, access to and correction of my personal information as well as the withdrawal of my consent, and I accept it.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_90\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >By checking this box:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_90'><div class='gchoice gchoice_55_90_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_90.1' type='checkbox'  value='I consent to the referred lawyer receiving my name and the nature of my request, in order to know that the referral comes from the Referral service and that they will receive my call.'  id='choice_55_90_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_90_1' id='label_55_90_1' class='gform-field-label gform-field-label--type-inline'>I consent to the referred lawyer receiving my name and the nature of my request, in order to know that the referral comes from the Referral service and that they will receive my call.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_91\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >By checking this box:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_91'><div class='gchoice gchoice_55_91_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_91.1' type='checkbox'  value='I consent to this form and the personal information it contains being kept by the Barreau de Montr\u00e9al for a maximum period of 3 years.'  id='choice_55_91_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_91_1' id='label_55_91_1' class='gform-field-label gform-field-label--type-inline'>I consent to this form and the personal information it contains being kept by the Barreau de Montr\u00e9al for a maximum period of 3 years.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_92\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >By checking this box:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_92'><div class='gchoice gchoice_55_92_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_92.1' type='checkbox'  value='I consent to the Barreau de Montr\u00e9al contacting me using the information provided on this form.'  id='choice_55_92_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_55_92_1' id='label_55_92_1' class='gform-field-label gform-field-label--type-inline'>I consent to the Barreau de Montr\u00e9al contacting me using the information provided on this form.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_55_93\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >By checking this box:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_55_93'><div class='gchoice gchoice_55_93_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_93.1' 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