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Phone Intake

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Caller Info

Today's Date

Calling on behalf of someone?

Client Information

Full Legal Name *

Date of Birth

Phone Number *

Email Address

Marital Status

Emergency Contact

Name

Relationship

Phone

Case Details

Charges / Allegations *

Is this a DUI case?

Date of Incident

Arrested or Cited?

Custody Status *

Out of custody 🔴 In custody Bail / Bond Own recognizance

Court Information

Courthouse

Court Date

Hearing Type

Background

Priors

Immigration Status

Prior convictions / arrests — list them out

Probation / Parole?

Prob / Parole details

Outstanding Warrants?

Warrant details

Other Pending Cases?

Pending case details

Spoke to Other Attorneys?

Employment Status

Employment details — what do they do / what have they done?

Military History

Physical / Mental / Drug / Alcohol Issues

Potential Witnesses

Incident & Arrest

Summary of what happened

Anything unusual about the arrest, search, or police conduct?

DUI — Additional Questions

Any property damage?

Any injuries?

Breath test — did they blow?

How many times did they blow?

BAC result(s)

Blood sample taken?

PAS (preliminary breath) test?

Field sobriety tests (FSTs)?

Administrative Per Se (APS) hearing scheduled?

DMV hearing requested within 10 days?

License suspended / confiscated?

Prior DUIs?

Additional DUI notes

Referral

How did they hear about us?

Vocational Training / Education

Next Steps

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