Have you ever been arrested for DUI/DWI before?

 
If 'yes', when was/were your previous alcohol-related conviction(s)?   

Your Current Arrest Matter: 

Date of Your Current Arrest?   

Was your license valid on this most current arrest (ie. not suspended or revoked for another reason)?

Did the officer take your driver's license and give you temporary license?

Think carefully about these next few questions: 

Approximately how many minutes went by from the time the officer stopped/contacted you until he put the handcuffs on you?   

 

Approximately what time were you first contacted by the officer?   

Approximately what time you were arrested (handcuffed)?   

Approximately how many minutes went by from the time you were arrested (when they handcuffed you) until you arrived at the blood, breath or urine test location?   

Approximately how many minutes went by from the time you arrived at the chemical test location until you took the first chemical test (blood, breath or urine test)?   
 

Have you contacted the Department of Motor Vehicles yet?

If you have not contacted the DMV, why not?    Not Selected I don't know what you are talking about It won't do any good I don't want a hearing I just have not set up a hearing appointment I was doing some research first My attorney didn't bother to mention a DMV hearing to me My attorney told me it would do no good The DMV staff on the telephone told me it would do no good The cop told me it would do no good Other

If 'other', please indicate why not?   

If you have contacted DMV, when is your revocation hearing (date and time)?   

Did you request the officer's presence?

If 'yes' and a Colorado matter, with which DMV Office if you know?    Not Selected Not Colorado I have not been notified. I don't know, I don't see the city, address, or telephone number listed Lakewood - 1881 Pierce St. Boulder-2850 Iris Ave., #F Other

If 'other', please indicate where you will have the hearing held?   

Analysis Questions - Probable Cause: 

Did the officer see you driving, or if s/he did not, did you admit to driving a vehicle?

Did the officer have a valid reason for stopping you in the vehicle?

What did the officer indicate to you as the reason for the traffic stop or contact with you (check all that apply)?

   Speeding Weaving Involved in accident - no injury to anyone Involved in accident - injury to at least one person Roadblock / checkpoint Unkown S/he didn't tell me

If none of the above apply, please indicate the reason for the stop of your vehicle or contact with you?   

Did you drink any alcoholic beverages, and/or take any drugs, within 10 hours of being stopped by the officer?

If you drank alcoholic beverages, what type (highlight all that apply)?

   None consumed Beer-regular Beer-microbrew Beer-malt liquor Wine-red Gin Vodka Rum Tequila Martini Long island ice tea Other

If 'Other', please indicate type of beverage?   

Think about the drinks you had. Many people underestimate how many drinks they had, or cannot remember. This can be extremely important to your case though. In order to calculate your Blood Alcohol Level please indicate how many drinks you had total (one drink is equal to a 12 ounce beer, a regular 4 ounce glass of wine, or, 1 shot or 1 ½ ounces-of hard liquor)?

Number of servings of alcohol:   

Approximately what time did you finish your LAST alcoholic beverage?   

If you were on prescription medications or other drugs, what type (highlight all that apply)?

   Not applicable Anti-depressant Pain medication Valium/tranquilizer Marijuana Methamphetamine Powdered cocaine 'Crack' cocaine Heroin Ecstasy Other

If 'Other', please indicate type of medication or drug?   
 

What size meal did you have within three (3) hours of drinking or drug use?
   Not Selected Hadn't eaten within the time limit Bar snacks Small meal Medium meal Large meal Extremely large meal Other

If 'Other', please indicate size of meal?   

Did you feel the effects of the alcohol you drank, or drugs you were taking, when you were driving (i.e. feel a buzz, feel drunk or high)?

If you drank after driving, please explain:
  
 

Analysis Questions-Reasonable Cause to Arrest:

Did you take any field balance/coordination (field sobriety tests - FST's) tests prior to being arrested and handcuffed?
 

Were you ordered or did you do them voluntarily?
 

Please select the field sobriety tests you were ordered to perform (check all that apply)?    Did not take any field tests Follow a pen, finger, or other object with your eyes Standing with my head titled back and eyes closed, feet together Standing on one foot for a period of time Patting your hands together Counting on your fingers Saying or writing the ABC's Walking a straight line, or heel-to-toe Touching your nose with finger Other

If 'Other', please indicate what they made you do?   

Did you blow into a field breathalyzer or hand-held type gadget?

If you know, what was the result of the hand-held breathalyzer gadget test?   

Did the officer advise you that you could refuse to take the hand-held gadget breath test?
 

Did you fail to satisfactorily perform the balance and coordination tests as demonstrated to you by the officer?

Analysis Questions - Chemical Test/Test Refusal: 

Did you take a blood, breath or urine test?

If you took a chemical test, did you take a blood, breath, or urine test?

Did you take the chemical test (blood, breath or urine at the station) within 2 hours of driving?

Did you select (choose for yourself) the chemical test if you took at least one (i.e. the blood, breath, or urine test)?

If 'yes' type in the test and the results if you know:   

If you are charged with refusing a chemical test, where or when did you supposedly refuse?    Not Selected I took the chemical test S/he told me I would have my license suspended if I refused, and I refused anyway. I refused during the initial vehicle stop or contact with the cop. I refused when they handcuffed me. I refused in the patrol car. I resused in the patrol car, on the ride to the chemical test location. I refused at the chemical test location. I refused everything from the beginning. I refused when he first stopped me. I refused when we were doing the field tests. I refused when at the station, but he didn't tell me I would loose my license if I refused. S/he told me I could refuse the test when he used a hand-held breathalyzer, so I did. S/he never told me I had to take a test and he didn't tell me I would loose my license for refusing.
 

If you refused, but later changed your mind, please give details:
  
 

Due Process Under the Law:

What type of law enforcement officer was the arresting officer (the one who gave you tests, handcuffed you, took you to jail)?
   Not Selected Highway Patrolman/Trooper Local Sheriff Deputy City Police Officer Other Law Enforcement Officer

Please input the arresting officer's last name and badge or serial number:   

Please input the agency that the officer worked for (ie. San Francisco Police Department):   

Did the officer treat you fairly and professionally?

Please enter any comments about the officer below:
  
 

City and State where arrest took place?   

For Colorado, scheduled to appear in which County?   

What date and time is your court date?   

Please enter any comments or things you think your attorney should know that is not asked for on questionnaire:
  

Have you consulted with another attorney?

Is it your goal to win your DUI case?

Is it your goal to save your Driver's License from suspension/revocation?

Are you aware that DUI/DWI cases can be successfully defended?

Are you aware that a conviction and/or driver's license suspension for DUI will result in insurance cancellation or an increase cost?

 
Personal Information - Strictly Confidential *-REQUIRED FIELDS:

Name: * 

Email Address:  

Your Home Address:  

Your ZIP code: * 

Primary Phone: * 

Secondary Phone:   

Cell Phone:   

Facsimile Number:   

Contact Preference (when is the best time to contact you)? *

Date of Birth:   

Driver License Number:   

Occupation:   

Annual Income:   

Place of Employment:   

What is your budget to defend your current case?