Criminal Intake Form

Please fill out the below form

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Name(Required)

First Last

Email(Required)

Phone(Required)

Date of Arrest(Required)

Location of Arrest(Required)

Arresting Agency (Sheriff/Police)(Required)

Case Number(Required)

Charges(Required)

Did you do a field sobriety test?

Yes

Did you blow in a breath-a-lyzer?

Yes

Did you have your blood drawn?

Yes

Your summary of events