Criminal Intake Form Fields marked with an * are required Name * Email * Phone * Date of Arrest * Location of Arrest * Arresting Agency (Sheriff/Police) * Case Number * Charges * Divider Did you do a field sobriety test? Yes No Did you blow in a breath-a-lyzer? Yes No Did you have your blood drawn? Yes No Your summary of events * If you are a human seeing this field, please leave it empty.