Hawkins DUI Law Intake Form

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Confidential Information

Full Name(Required)
MM slash DD slash YYYY
How did you hear about us?

Address(Required)
Preferred Number to call you on
Mailing Address (If different from above)
Prior DUI's
Arrest Date
Police Agency
Court
Disposition
 
Okay to send all correspondence via email?
Arrest Information
Arrest Date / Time
Citation or Warrant No.
Police Agency
Court
Court Date
Type of Test Taken
Commercial Drivers License (CDL)(Required)
Does work require you to travel
Do you travel for work
Access to public transportation
Marital Status

Okay to discuss with Spouse/Partner