Apply | Queen's Law Clinics

Due to recent Covid restrictions, wait times for service at the Queen’s Elder Law Clinic are longer than normal. Thank you for your patience.

QELC assists seniors in Kingston and the surrounding communities who would otherwise have difficulty affording legal counsel. The QELC can only provide legal services to clients who cannot otherwise afford them.

To determine eligibility, the QELC asks prospective clients to complete an application form wherein they are asked to provide personal and financial information. All information provided to the QELC is held in strict confidence and shall not be disclosed to any third parties without your express consent.

Client application forms are available at the Queen’s Law Clinics office. Should you require assistance completing this form, please call 613-533-2102 to book an appointment.

QELC Application Form

The Queen’s Elder Law Clinic can only provide pro bono legal services to clients with limited budgets who could not otherwise afford legal services. While we provide a broad range of legal services, there are some matters with which we cannot assist clients.

This form will be kept strictly confidential, and will only be seen by the Director of QELC and the student caseworkers. It will be used solely to confirm whether it is appropriate for QELC to provide you with legal services. We reserve the right to request further financial disclosure.

For more information, you can reach the Elder Law Clinic at 613-533-2102, or email us at qelc@queensu.ca.

Downloadable PDF

Queen's Elder Law Clinic Application Form

Contact Information:

Name

Date of Birth

Occupation

Phone Number

Email Address

Street Address

City / Town

Province

Postal Code

Additional Questions:

Is the client physically and mentally able to visit the clinic at 303 Bagot Street, Fifth Floor, in downtown Kingston?

Access to Technology

I have access to a device with a front facing Camera and Microphone such as a Smart Phone, Tablet and/or Laptop?

I am familiar and comfortable using this device on my own?

I have attended Video Conferences in the past and, I am familiar and comfortable using software such as FaceTime, Skype or Zoom, etc.

I am willing and comfortable with attending Video Conferences with QELC staff throughout the provision of QELC services

I have access to a stable and reliable internet connection

File Information

What would you like QELC's help with?

For the situation you've described above, list any people or organization with conflicting interests:

Is there a date by which this situation must be resolved?

Financial Information

Household Income?

Savings?

Real Property?

Other significant assets?

Debt?

How did you hear about us?

Please explain

Do you know a clinic member personally?

Referred by Someone?

Name?

I certify the above information to be accurate and complete to the best of my knowledge.