Free DUI Case Evaluation

Want to know more about your options? Fill out this online questionaire for a free evaluation.

What date were you arrested?
Have you received any paperwork from the courts? Yes No
Have you received any paperwork from the DMV? Yes No
Have you consulted with another attorney?Yes No
Are you currently represented by another attorney? Yes No
Where were you arrested (city and county)?
What department/agency was the arresting officer from?
If you know the officer's name, please enter it here:
What reason did the officer give for stopping you?
Did you perform field sobriety tests? Yes No
If so, check the tests you performed:
Eye Check (HGN)
Walk a Line (WAT)
Stand on One Foot (OLS)
Alphabet
Counting
Finger Count
Stationary Balance
Other (describe)

Did you take a handheld breath test at the roadside? Yes No
If so, tell us the numeric result if you know what it was.
Did you take a breath test at the police station?Yes No
If so, tell us the numeric result if you know what it was:
In the 20 minutes right before the breath test, did you put anything in your mouth (food, gum, drinks, breath strips/mouthwash, tobacco, etc.)? Yes No
If so, please tell us exactly what it was:
Were you left alone at the station before your breath was tested? Yes No
Do you have any oral piercings? Yes No
Do you wear dentures or have other dental implants? Yes No
Did the officer check your mouth before making you take the breath test? Yes No
Did you admit to drinking or using drugs? Yes No
If so, what did you tell the officer?
Do you have or suffer from any of the following health conditions?(check all that apply)
Diabetes
More than 50 pounds overweight
Arthritis in your joints
Knee problems
Ankle problems
Any problems of the legs
Back problems
Head injury
Vision problems
Vertigo (dizziness)
Reflux/Heartburn
Asthma or other lung/breathing disorders
Other illness (cold, flu, fever, etc.)
Do you have any other physical or health limitations or difficulties not listed above? Yes No
If yes, please describe them briefly:

Do you have any prior DUI arrests? Yes No
If so, how many?
Please tell us your name(required):
Please tell us your phone number(required):
Please enter your email address(required):
Please let us know the best time to contact you:

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