[hidden pp_contact_id default:""] [hidden pp_account_id default:""] [hidden sio_contact_id default:""] [hidden utm_source default:""] [hidden utm_medium default:""] [hidden utm_campaign default:""] [hidden utm_term default:""] [hidden utm_content default:""] [hidden source_url default:""]

Contact details of the person concerned

Information about the person who is the subject of the immigration procedure.

[select* rempli_par first_as_label "Who is filling out this form?" "I am the person concerned by the procedure" "I am filling out on behalf of someone else"]
[group tiers_fields]

Your contact details (person filling out the form)

[select* relation_tiers first_as_label "Your relationship with the person concerned" "Employer" "HR Manager" "Family member" "Spouse" "Friend" "Lawyer/Legal representative" "Other"]
[text* nom_tiers placeholder "Your full name"]
[email* email_tiers placeholder "Your email"]
[tel* telephone_tiers placeholder "Your phone number"]
[/group]
[email* email placeholder "Email of the person concerned"]
[text* prenom placeholder "First name"]
[text* nom placeholder "Last name"]
[select* sexe first_as_label "Gender" "Male" "Female" "Other"]
[date* date_naissance placeholder "Date of birth"]
[text* nationalite placeholder "Nationality"]
[tel* telephone placeholder "Phone (e.g. +32 470 00 00 00)"]
[text* pays_residence placeholder "Country of residence"]
[text* adresse placeholder "Address (street and number)"]
[text* code_postal placeholder "Postal code"]
[text* ville placeholder "City"]
[select* langue_consultation first_as_label "Preferred consultation language" "French" "English" "Spanish"]
[select* source_contact first_as_label "How did you hear about Halabi Law Firm?" "Google search" "Recommendation from a former client" "Recommendation from a professional partner" "Masterclass/Webinar" "LinkedIn" "Facebook" "Instagram" "Website avocat-halabi.com" "Other"]
[checkbox newsletter_subscription "Yes, I would like to receive the newsletter to stay informed about changes in laws, procedures, and free thematic masterclasses"]
[acceptance autorisation_contact] I authorize Halabi Law Firm to process my data and contact me as part of my case follow-up
[hidden pp_contact_id default:""] [hidden pp_account_id default:""] [hidden sio_contact_id default:""]

What is your situation?

[select* situation_actuelle first_as_label "What is your current situation?" "I have legal residency in Belgium or Europe" "I reside abroad" "I am in Belgium with a valid visa" "I am in Belgium without legal residency"]
[group procedures_sejour_legal]
[select* type_procedure first_as_label "Type of procedure requested" "Family reunification" "Student visa or residency" "Single permit or EU Blue Card" "Residency and/or work permit renewal" "Unlimited or permanent residency (Card B, C, E+, F+, L...)" "Belgian nationality" "Professional card" "Private means (Rentier)" "Regularization (9bis/9ter)" "Appeal against a decision" "Appeal against a decision - Family reunification" "Appeal against a decision - Professional card" "Appeal against a decision - Single permit" "Appeal against a decision - Humanitarian regularization (9bis)" "Appeal against a decision - Medical regularization (9ter)" "Appeal against a decision - Private means (Rentier)" "Appeal against a decision - Nationality" "I don't know / Need advice"]
[/group] [group procedures_etranger]
[select* type_procedure_etranger first_as_label "Type of procedure requested" "Family reunification" "Student visa" "Single permit or EU Blue Card" "Professional card" "Tourist visa" "Private means (Rentier)" "Appeal against a decision" "Appeal against a decision - Family reunification" "Appeal against a decision - Professional card" "Appeal against a decision - Single permit" "Appeal against a decision - Humanitarian regularization (9bis)" "Appeal against a decision - Medical regularization (9ter)" "Appeal against a decision - Private means (Rentier)" "Appeal against a decision - Nationality" "I don't know / Need advice"]
[/group] [group procedures_visa_c]
[select* type_procedure_visa_c first_as_label "Type of procedure requested" "Student visa or residency" "Family reunification" "Private means (Rentier)" "Medical regularization (9ter)" "Humanitarian regularization (9bis)" "Appeal against a decision" "Appeal against a decision - Family reunification" "Appeal against a decision - Professional card" "Appeal against a decision - Single permit" "Appeal against a decision - Humanitarian regularization (9bis)" "Appeal against a decision - Medical regularization (9ter)" "Appeal against a decision - Private means (Rentier)" "Appeal against a decision - Nationality" "I don't know / Need advice"]
[select* retour_pays_origine first_as_label "Are you willing to return to your country of origin?" "Yes, if the chances of success are at least 80%" "No, I prefer to stay in Belgium" "I don't know"]
[/group] [group procedures_sejour_illegal]
[select* type_procedure_illegal first_as_label "Type of procedure requested" "Family reunification with a Belgian, European, or person with legal residency" "Medical regularization (9ter)" "Humanitarian regularization (9bis)" "Appeal against a decision" "Appeal against a decision - Family reunification" "Appeal against a decision - Professional card" "Appeal against a decision - Single permit" "Appeal against a decision - Humanitarian regularization (9bis)" "Appeal against a decision - Medical regularization (9ter)" "Appeal against a decision - Private means (Rentier)" "Appeal against a decision - Nationality" "I don't know / Need advice"]
[/group] [group champs_communs_belgique]
[date* date_arrivee_belgique placeholder "Date of arrival in Belgium"]
[select* type_carte_sejour first_as_label "Type of residence card in your possession" "Card A (limited stay)" "Card B (limited stay)" "Card C (unlimited stay)" "Card D (EU permanent residency)" "Card F (EU family member)" "Card F+ (permanent EU family stay)" "Card H (EU Blue Card)" "Annex 15" "Annex 35" "Registration certificate" "No card currently" "Other"]
[textarea description_situation placeholder "Describe your current situation..."]
[/group] [group champs_communs_etranger]
[textarea description_situation_etranger placeholder "Describe your current situation..."]
[/group] [group questions_regroupement]

Specific questions - Family reunification

[select* membre_famille first_as_label "Who do you wish to join in Belgium?" "My Belgian or European spouse/partner" "My spouse/partner with legal residency in Belgium" "My Belgian or European child" "My child with legal residency in Belgium" "My Belgian or European parent" "My parent with legal residency in Belgium" "Other family member"]
[group autre_membre_famille]
[text* autre_membre_preciser placeholder "Specify the family relationship"]
[/group]
[select* statut_membre_famille first_as_label "Residency status of the person you wish to join" "Belgian nationality" "European nationality" "Card A, B, C, D (long stay)" "Card F or F+ (permanent/unlimited stay)" "Recognized refugee or subsidiary protection" "I'm not sure exactly"]
[group nationalite_europeenne_preciser]
[text* nationalite_europeenne placeholder "Specify the European country"]
[/group]
[textarea* revenus_nets_mensuels placeholder "What is this person's net monthly income? Please specify the amount and type (salary, self-employment income, rental income, pension, unemployment benefits, mutual insurance, CPAS...)"]
[select* situation_familiale first_as_label "What is your current family situation?" "Married" "Legal cohabitant" "Partner (de facto relationship)" "Parent/child" "Other"]
[group duree_mariage_cohab]
[text* duree_relation placeholder "How long have you been married or in legal cohabitation?"]
[/group]
[select* enfants_communs first_as_label "Do you have children together?" "Yes" "No"]
[group nombre_enfants]
[number* combien_enfants min:1 max:20 placeholder "How many children?"]
[/group]
[select* vivent_ensemble first_as_label "Do you currently live together?" "Yes, we live together" "No, we live separately"]
[select* sejour_belgique_passe first_as_label "Have you previously stayed in Belgium?" "No" "Yes"]
[group sejour_passe_details]
[textarea sejour_passe_preciser placeholder "Specify dates and type of stay"]
[/group]
[/group] [group questions_etudiant]

Specific questions - Student visa or residency

[select* situation_etudiant first_as_label "Your current situation" "I reside abroad and wish to study in Belgium (first application)" "I am already a student in Belgium and wish to renew my residency" "I am in Belgium with a visa C and wish to change status to student"]
[group pays_residence_etranger]
[text* pays_residence_legale placeholder "Current country of legal residence"]
[/group] [group date_arrivee_etudiant]
[date* date_arrivee_etudiant_be placeholder "Date of arrival in Belgium"]
[/group]
[select* inscription_confirmee first_as_label "Have you already been admitted to an educational institution in Belgium?" "Yes" "Not yet" "Application in progress"]
[group etablissement_admis]
[text* nom_etablissement placeholder "Which institution?"]
[/group]
[select* etablissement_reconnu first_as_label "Is it a recognized institution?" "Yes" "No" "I don't know"]
[select* type_etudes first_as_label "Type of studies planned" "Bachelor's (1st university cycle)" "Master's (2nd university cycle)" "Doctorate" "Preparatory year / Bridging course" "Professional training" "Language courses" "Other"]
[select* niveau_etudes_actuel first_as_label "Current level of education completed" "Secondary education" "Bachelor's" "Master's" "Doctorate" "Other"]
[checkbox financement_etudes "Sponsorship by a third party (parent, guardian)" "Personal income" "Scholarship" "Student loan" "Personal savings" "Other"]
[textarea* garant_financement placeholder "Do you have a sponsor or have you blocked the necessary amount to finance your studies? Please specify"]
[select* montant_850_mois first_as_label "Do you have a minimum of 850 EUR/month for your subsistence?" "Yes" "No" "I don't know"]
[group ects_renouvellement]
[text* ects_valides placeholder "How many ECTS credits have you validated this year? (e.g. 45/60)"]
[/group]
[select* etudiant_refus_visa first_as_label "Have you ever had visa or residency refusals in Belgium?" "No" "Yes"]
[group refus_visa_etudiant_details]
[textarea refus_visa_preciser placeholder "Specify the refusals (dates and reasons)"]
[/group]
[select* signalement_schengen_etudiant first_as_label "Have you ever received entry bans or Schengen alerts in Belgium or another EU state?" "No" "Yes"]
[group signalement_etudiant_details]
[textarea signalement_etudiant_preciser placeholder "Specify the situation"]
[/group]
[/group] [group questions_permis_unique]

Specific questions - Single permit or EU Blue Card

[select* offre_confirmee first_as_label "Do you already have an employer ready to hire you in Belgium?" "Yes" "No, but I would like to know my options"]
[select* region_occupation first_as_label "Region where you will work if the single permit is granted" "Flanders" "Brussels" "Wallonia"]
[group employeur_details]
[text* secteur_activite placeholder "Company's sector of activity"]
[select* type_fonction first_as_label "Type of position offered" "Highly qualified (min. 3-year higher education degree)" "Shortage occupation" "Other position"]
[text* poste_fonction placeholder "Specify the position or role"]
[number salaire_mensuel_brut min:0 placeholder "Proposed gross monthly salary (in EUR), if known"]
[select* type_contrat first_as_label "Type of contract offered" "Permanent contract (CDI)" "Fixed-term contract (CDD)" "I don't know yet"]
[group duree_cdd]
[text* duree_contrat_cdd placeholder "Duration of the fixed-term contract"]
[/group] [/group]
[textarea* niveau_etudes_diplomes placeholder "Your education level and degrees obtained - please specify"]
[number* annees_experience min:0 max:50 placeholder "Years of professional experience in this field"]
[select* metier_penurie first_as_label "Is this a shortage occupation?" "Yes" "No" "I don't know"]
[/group] [group questions_renouvellement]

Specific questions - Residency and/or work permit renewal

[select* type_visa_renouvellement first_as_label "Which type of visa/residency do you wish to renew?" "Student visa" "Single permit" "Family reunification" "Professional card" "Other"]
[select* situation_changee first_as_label "Has your situation changed since your last visa/residency application?" "No" "Yes"]
[select* separe_conjoint first_as_label "Have you separated from your spouse? (if family reunification)" "No" "Yes" "Not applicable"]
[/group] [group questions_sejour_illimite]

Specific questions - Unlimited or permanent residency (Card B, C, E+, F+, L...)

[select* cinq_annees_sejour first_as_label "Do you have more than 5 years of uninterrupted legal residency?" "Yes" "No" "Almost (between 4 and 5 years)"]
[select* travail_actuel_carte_c first_as_label "Are you currently employed?" "Yes" "No"]
[textarea* revenus_origine_carte_c placeholder "Amount and source of your income - please specify"]
[/group] [group questions_nationalite]

Specific questions - Belgian nationality

[number* annees_sejour_belgique min:0 max:50 placeholder "How many years have you been legally living in Belgium?"]
[date* date_arrivee_nationalite placeholder "Date of arrival in Belgium"]
[select* sejour_continu first_as_label "Has your stay in Belgium been continuous and legal without interruption?" "Yes, no interruption" "No, there have been interruptions" "I'm not certain"]
[group interruptions_sejour]
[textarea interruptions_preciser placeholder "Specify the interruptions (dates and durations)"]
[/group]
[select* base_nationalite first_as_label "On what basis do you wish to apply for nationality?" "5 years of uninterrupted legal residence" "10 years of uninterrupted legal residence" "Marriage with a Belgian or parent of a Belgian child (3 years of marriage + 5 years of residence)" "Pensioner or disabled and 5 years of residence" "Born in Belgium / Belgian parents" "I don't know"]
[select* travail_belgique first_as_label "Do you work in Belgium?" "Yes, continuously for several years" "Yes, but with interruptions" "No"]
[group travail_continu]
[select* cinq_ans_travail first_as_label "Do you have 5 years of uninterrupted work?" "Yes" "No"]
[/group]
[select* integration_faite first_as_label "Have you completed an integration program in Belgium?" "Yes" "No" "In progress"]
[group region_integration]
[select* region_parcours first_as_label "In which region?" "Flanders" "Brussels" "Wallonia"]
[/group]
[textarea* niveau_langue_nat placeholder "Language level A2 or B1 - please specify the language and level"]
[checkbox langues_parlees "French" "Dutch" "German" "Other"]
[select* diplome_belgique first_as_label "Do you have a degree obtained in Belgium?" "Yes, secondary education" "Yes, higher education" "No"]
[select* formation_400h first_as_label "Have you completed a professional training of at least 400 hours?" "Yes" "No"]
[select* travail_salarie_independant first_as_label "Have you worked in Belgium as an employee or self-employed?" "Yes" "No"]
[group jours_travail_belgique]
[text* nb_jours_travail placeholder "How many days in total?"]
[/group]
[select* nat_attaches first_as_label "Do you have ties in Belgium?" "Yes" "No"]
[group attaches_nat_details]
[textarea* attaches_nat_preciser placeholder "Please specify your ties (Belgian family + relationship, properties, etc.)"]
[/group]
[select* marie_belge first_as_label "Are you married to a Belgian citizen?" "Yes" "No"]
[group duree_mariage_belge]
[text* duree_mariage placeholder "For how long?"]
[/group]
[select* parent_enfant_belge first_as_label "Are you the parent of a Belgian child?" "Yes" "No"]
[group age_enfant_belge]
[number* age_enfant min:0 max:50 placeholder "Child's age"]
[/group]
[select* condamnations_penales first_as_label "Do you have criminal convictions in Belgium or abroad?" "No" "Yes"]
[group condamnations_details]
[textarea condamnations_preciser placeholder "Specify the convictions"]
[/group]
[select* dossier_parquet first_as_label "To your knowledge, is there an open investigation file in your name at the Prosecutor's Office?" "No" "Yes" "I don't know"]
[group dossier_parquet_details]
[textarea dossier_parquet_preciser placeholder "Specify the nature of the file"]
[/group]
[select* procedure_judiciaire first_as_label "Have you ever filed a complaint or been involved in legal proceedings (even as a victim or witness)?" "No" "Yes"]
[group procedure_judiciaire_details]
[textarea procedure_judiciaire_preciser placeholder "Specify the situation"]
[/group]
[/group] [group questions_rentier]

Specific questions - Private means (Rentier)

[select* rentier_revenus first_as_label "Do you have income exceeding 2,000 EUR/month as a single person or 3,000 EUR/month with a family?" "Yes" "No" "I'm not sure"]
[select* rentier_attaches first_as_label "Do you have ties in Belgium?" "Yes" "No"]
[group rentier_attaches_details]
[textarea* rentier_attaches_preciser placeholder "Please specify your ties"]
[/group]
[/group] [group questions_touriste]

Specific questions - Tourist visa

[select* touriste_refus_visa first_as_label "Have you ever been refused a Belgian visa in the past?" "No" "Yes"]
[select* touriste_signalement_schengen first_as_label "Have you ever been subject to a Schengen alert in the past?" "No" "Yes" "I don't know"]
[textarea* but_sejour_touriste placeholder "Purpose of your stay - please specify"]
[textarea* garanties_retour placeholder "Do you have proof of return guarantees to your country? (e.g. family, work, property...) Please detail"]
[/group] [group questions_9ter]

Specific questions - Medical regularization (9ter)

[select* maladie_grave first_as_label "Do you suffer from a serious illness requiring treatment in Belgium?" "Yes" "No"]
[text* nature_maladie placeholder "Nature of the illness (without disclosing sensitive medical details)"]
[select* traitement_disponible_origine first_as_label "Is this treatment available or accessible in your country of origin?" "No, not available at all" "No, available but inaccessible (cost, distance, etc.)" "Yes, available and accessible" "I don't know"]
[select* suivi_medical_belgique first_as_label "Are you currently receiving medical care in Belgium?" "Yes" "No"]
[group suivi_medical_details]
[text* nom_hopital_medecin placeholder "Name of the hospital or treating physician"]
[/group]
[text* duree_traitement placeholder "How long have you been in treatment?"]
[select* rapports_medicaux_recents first_as_label "Do you have recent medical reports (less than 3 months old)?" "Yes" "No"]
[date* date_arrivee_9ter placeholder "Date of arrival in Belgium"]
[select* demande_9ter_passee first_as_label "Have you previously submitted a medical regularization (9ter) application?" "No" "Yes"]
[group resultat_9ter_passe]
[select* resultat_9ter first_as_label "What was the result?" "Accepted" "Refused" "Pending"]
[/group]
[/group] [group questions_9bis]

Specific questions - Humanitarian regularization (9bis)

[select* duree_belgique_9bis first_as_label "How long have you been in Belgium?" "Less than 1 year" "1 to 3 years" "3 to 5 years" "More than 5 years"]
[select* procedures_passees first_as_label "Have you previously submitted other immigration procedures in Belgium?" "No" "Yes"]
[group procedures_passees_details]
[textarea procedures_passees_lesquelles placeholder "Which ones and what were the results? (Describe the procedures submitted and their outcome)"]
[/group]
[select* famille_belgique_9bis first_as_label "Do you have family in Belgium?" "Yes" "No"]
[group famille_belgique_details]
[text* famille_belgique_qui placeholder "Who and what is their residency status?"]
[/group]
[checkbox attaches_belgique "Children enrolled in school in Belgium" "Work (even if irregular)" "Real estate property" "Community involvement, volunteering" "Long duration of residence" "Other"]
[select* projet_mariage_cohab first_as_label "Do you have a marriage or legal cohabitation project with a person with legal residency or a Belgian/European citizen?" "No" "Yes"]
[group projet_mariage_details]
[text* projet_mariage_preciser placeholder "Specify the situation"]
[/group]
[select* projet_reconnaissance first_as_label "Do you have a child recognition project involving a child with legal residency or Belgian/European nationality?" "No" "Yes"]
[group projet_reconnaissance_details]
[text* projet_reconnaissance_preciser placeholder "Specify the situation"]
[/group]
[textarea* raisons_pas_retour placeholder "Why can you not return to your country of origin? Explain the exceptional circumstances (minimum 300 characters)" minlength:300]
[select* dispose_retour_temporaire first_as_label "Are you willing to temporarily return to your country of origin to submit a legal procedure?" "Yes" "No"]
[group raison_pas_retour_temporaire]
[textarea raison_refus_retour placeholder "Explain why you cannot temporarily return"]
[/group]
[select* documents_identite first_as_label "Do you have documents proving your identity?" "Yes, valid passport" "Yes, expired passport" "Yes, identity card" "No, no documents"]
[textarea* description_situation_9bis placeholder "Describe your situation as precisely as possible: reasons for coming to Belgium, family/professional/social ties, circumstances preventing you from returning to your country, any important information (minimum 500 characters)" minlength:500]
[/group] [group questions_regularisation]

Specific questions - Regularization

[select* motif_regularisation first_as_label "Reason for regularization request" "Article 9bis (exceptional circumstances)" "Article 9ter (medical reasons)" "I don't know"]
[select* duree_belgique first_as_label "How long have you been in Belgium?" "Less than 1 year" "1 to 3 years" "3 to 5 years" "More than 5 years"]
[group questions_9bis_generique]
[textarea* raisons_pas_retour_gen placeholder "Reasons preventing a return to your country of origin - please detail"]
[textarea* raisons_humanitaires_gen placeholder "Humanitarian reasons justifying your request - please detail"]
[/group] [group questions_9ter_generique]
[textarea* pathologie_severite_gen placeholder "Type of condition and degree of severity according to your doctor - please specify"]
[select* traitement_dispo_gen first_as_label "Is the treatment available in your country of origin?" "Yes" "No" "I don't know"]
[textarea* traitement_details_gen placeholder "Please provide details"]
[/group]
[/group] [group questions_recours]

Specific questions - Appeal

[select* type_decision first_as_label "Type of decision contested" "Visa refusal" "Residency refusal" "Order to leave the territory" "Withdrawal of residency" "Renewal refusal" "SIS/Schengen alert to be removed" "Entry ban" "Other"]
[date* date_decision placeholder "Date of notification of the decision"]
[select* recours_oqt first_as_label "Have you received an order to leave the territory?" "Yes" "No"]

Important: Please send a copy of the decision to secretariat@avocat-halabi.com or upload it in the Documents section below.

[/group]

Administrative and judicial history

This information allows us to fully assess your situation.

[group antecedents_regroupement]
[select* rf_oqt first_as_label "Have you ever been issued an order to leave the territory?" "No" "Yes"]
[group rf_oqt_details]
[textarea rf_oqt_preciser placeholder "Specify (date, country, circumstances)"]
[/group]
[select* rf_interdiction first_as_label "Have you ever been issued an entry ban?" "No" "Yes"]
[group rf_interdiction_details]
[textarea rf_interdiction_preciser placeholder "Specify (date, duration, country)"]
[/group]
[select* rf_signalement_schengen first_as_label "Have you ever been subject to a Schengen alert in Belgium or another EU state?" "No" "Yes" "I don't know"]
[group rf_signalement_details]
[textarea rf_signalement_preciser placeholder "Specify the situation"]
[/group]
[select* rf_expulsion first_as_label "Have you ever been subject to an expulsion order?" "No" "Yes"]
[group rf_expulsion_details]
[textarea rf_expulsion_preciser placeholder "Specify (date, country)"]
[/group]
[select* rf_condamnations first_as_label "Have you ever been convicted of criminal offenses in Belgium or another EU state?" "No" "Yes"]
[group rf_condamnations_details]
[textarea rf_condamnations_preciser placeholder "Specify the convictions"]
[/group]
[select* rf_mariage_suspect first_as_label "Have you recently been subject to a suspected marriage investigation?" "No" "Yes"]
[group rf_mariage_suspect_details]
[textarea rf_mariage_suspect_preciser placeholder "Specify the situation"]
[/group]
[select* rf_decisions_negatives first_as_label "Have you previously received negative decisions?" "No" "Yes"]
[group rf_decisions_negatives_details]
[textarea rf_decisions_preciser placeholder "Specify the procedure and result"]

Please attach a copy of the decisions in the Documents section.

[/group]
[/group] [group antecedents_standard]
[select* antecedent_oqt first_as_label "Have you ever been issued an order to leave the territory?" "No" "Yes"]
[group antecedent_oqt_details]
[textarea antecedent_oqt_preciser placeholder "Specify (date, country, circumstances)"]
[/group]
[select* antecedent_interdiction first_as_label "Have you ever been issued an entry ban?" "No" "Yes"]
[group antecedent_interdiction_details]
[textarea antecedent_interdiction_preciser placeholder "Specify (date, duration, country)"]
[/group]
[select* antecedent_signalement_schengen first_as_label "Have you ever been subject to a Schengen alert in Belgium or another EU state?" "No" "Yes" "I don't know"]
[group antecedent_signalement_details]
[textarea antecedent_signalement_preciser placeholder "Specify the situation"]
[/group]
[select* antecedent_expulsion first_as_label "Have you ever been subject to an expulsion order?" "No" "Yes"]
[group antecedent_expulsion_details]
[textarea antecedent_expulsion_preciser placeholder "Specify (date, country)"]
[/group]
[select* antecedent_condamnations first_as_label "Have you ever been convicted of criminal offenses in Belgium or another EU state?" "No" "Yes"]
[group antecedent_condamnations_details]
[textarea antecedent_condamnations_preciser placeholder "Specify the convictions"]
[/group]
[select* antecedent_decisions_negatives first_as_label "Have you previously received negative decisions?" "No" "Yes"]
[group antecedent_decisions_negatives_details]
[textarea antecedent_decisions_preciser placeholder "Specify the procedure and result"]

Please attach a copy of the decisions in the Documents section.

[/group]
[/group]

Documents and information

Upload your supporting documents and add any additional information.

Supporting documents (decisions, evidence, passport, etc.) - Accepted formats: PDF, JPG, PNG. Max size: 10 MB per file.

[file documents_upload limit:25mb filetypes:pdf|jpg|jpeg|png] [file documents_upload_1 limit:25mb filetypes:pdf|jpg|jpeg|png] [file documents_upload_3 limit:25mb filetypes:pdf|jpg|jpeg|png] [file documents_upload_4 limit:25mb filetypes:pdf|jpg|jpeg|png] [file documents_upload_5 limit:25mb filetypes:pdf|jpg|jpeg|png] [file documents_upload_6 limit:25mb filetypes:pdf|jpg|jpeg|png] [file documents_upload_7 limit:25mb filetypes:pdf|jpg|jpeg|png] [file documents_upload_8 limit:25mb filetypes:pdf|jpg|jpeg|png] [file documents_upload_9 limit:25mb filetypes:pdf|jpg|jpeg|png] [file documents_upload_10 limit:25mb filetypes:pdf|jpg|jpeg|png]
[textarea message placeholder "Additional information or questions - Describe your situation in detail, ask your questions, or add any information useful for our analysis..."]

Your appointment

[select* urgence first_as_label "Level of urgency" "Very urgent (less than 1 week)" "Urgent (less than 1 month)" "Normal (1 to 3 months)" "Not urgent / Preventive consultation"]
[select* type_accompagnement first_as_label "Type of support sought" "Consultation: I plan to start a procedure with the firm" "I don't know yet"]
[checkbox* acceptation_conditions "I accept that my data will be processed in accordance with the Halabi Law Firm's privacy policy"]
[submit class:btn-submit class:cta-component "Submit my request"]

Confirmation screen rendered outside CF7 form.