New Client Intake: Criminal Defense

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Please complete this intake to help us check for conflicts and prepare for your consultation. All information is confidential.

Email *

Your Full Name (First, Middle, Last) and Date of Birth (DD/MM/YYYY) *

Name(s) of any Co-Defendants or Alleged Victims (Required for conflict of interest check. If none, please type "None") *

Your Phone Number *

Your Home or Mailing Address *

County Where Charges are Filed (or where incident occurred) *

What type of matter do you need help with? *

What is your current custody status?

I am out of custody

I am currently in jail

I am posting bond soon / Warrant active

Clear selection

Date of Incident or Arrest

YYYY

Is there a court date currently scheduled?

Yes

I am not sure

Clear selection

If yes, when is the court date?

YYYY

What are the specific charges? (If known)

Approximate Annual Income (or funds available for defense)

Please provide a brief summary of the immediate situation (The Facts).

Have you used this firm for any previous legal matter?

Yes, I have

Clear selection

How did you hear about us? *

Send me a copy of my responses.

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