Nickname (if different)
Email *
Cell Number (no dashes or spaces please) *
What sort of legal matter do you have? * I don't know, or I'm not sure. Automobile/Motorcycle Accident Child Custody (Unmarried Parents) Criminal Charge (other than DUI) Divorce DUI Family Law (other than divorce) Firearms Rights Personal Injury (other than an automobile/motorcycle accident) Restraining Order Wrongful Death
Can I please get your date of birth?
What is the full legal name of the driver? *
In what city or town did the accident occur? *
Did the police respond any take any sort of report? * Yes No
Was anyone in any of the vehicles involved injured? * Yes No
If you have insurance, who is the carrier (insurance company that has your policy)?
If the other driver has insurance, who is the carrier (insurance company that has their policy)?
If a divorce case has been filed, please provide us with the county and case number (e.g. "Multnomah 23DR012345"):
If the case involves children, what are their names and ages?
If you and/or your spouse own a home, what do you estimate is the equity (e.g. current fair market value minus any mortgage or liens)?
What is your average gross monthly wage? *
What is your spouse's average gross monthly wage? *
What would you estimate is the sum total of all retirement funds held either jointly, by you, or your spouse? *
What would you estimate is the sum total of all other savings or investments held either jointly, by you, or your spouse? *
What would you estimate is the sum total of all debts held either jointly, by you, or your spouse? *
In which city or town were you arrested or cited? *
If you were asked to perform a breath test, do you remember what you blew (e.g. 0.08, 0.10, 0.15)?
Have you had any other DUI arrests in the last 15 years? * Yes No
Do you hold a CDL (Commercial Driver's License)? * Yes No
Did the DUI involve an accident which resulted in anyone-- including yourself-- being injured? * Yes No
What crime(s) have you been arrested for, charged with, or do you expect to be charged with? *