Criminal Law Intake Form

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Client Information

Name(Required)

Date of Birth

Age

Gender

Male

Female

Address

Street Address Address Line 2 City ZIP Code

Phone

Occupation

Marital Status

Emergency Contact Name

Emergency Contact Phone Number:

Case Information

Type of Offense

Date of Incident

Location of Incident

Law Enforcement Agency Involved

Case Number (if any)

Were Charges Filed?

If yes, please provide details

Is the Client currently detained?

If yes, where?

Legal Representation

Have you retained an attorney for this matter?

If yes, please provide attorneys name and contact information:

What is your preferred outcome for this case?

Background Information:

Describe the events leading to the incident:

Have you been involved in any prior legal issues?

If yes, please provide details

Are there any court orders, such as restraining orders or probation, currently in effect?

If yes, please provide details

Witnesses and Evidence

Are there any witnesses to the incident?

If yes, please provide their names and contact information

Is there any evidence relevant to your case?

If yes, please describe

How did you hear about our firm?

Is there any other information you believe is important for us to know?

Call Us Now :

Call Us Now :

Criminal Law Intake Form