Contact Us

If you are facing a charge for DUI/Drunk Driving, you can receive a free evaluation of you case by completing the confidential questionnaire below, or by calling us at (815) 469-0101

If a field does not apply to you, please type 'N/A' in the field.

*Name:


Company:


Home Address


City:


State:


Zip:


Home Phone:


Cell Phone:


Work Phone:


*E-mail Address:


Are you interested in fighting your case for the best result possible? Yes
No

Date of Arrest:


Time of Arrest:


Town/Municipality Where Arrest Occured:


Day of Week:


Court Date:


Time of Court:


Place of Court:


Street or Location Where You Were Stopped:


Was there a breath test taken on the scene?
Yes
No

Result:


Was there a breath test at the police station?
Yes
No

Result:


Was there a blood test taken?
Yes
No

Result:


Is this your first arrest for a DUI?
Yes
No

Please list all prior DUI/DWI/Drunk Driving Arrests:


Other Tickets Received:
Improper Lane Usage
Speeding

Why were you stopped, according to the police officer?


Was there an accident?
Yes
No

Was anyone injured?
No one was hurt
Myself
Passenger in my vehicle
Passenger in another vehicle
Pedestrian
Not Sure

Were you given field sobriety tests at the scene, hospital, or at the police station?
Yes
No

Which tests were given? (Check all that apply):
Portable Breath Test at Scene
Eye Test (also known as Horizontal Gaze Nystagmus)
Walk the Line
Finger to the Nose
Counting
Alphabet
Stand on one Leg

What other tests were given?


Did any police tell you that the tests were optional (you could refuse)?
Yes
No

Were you videotaped at the scene or police station?
Yes
No

Do you want to challenge the possible suspension of your drivers license?
Yes
No

Did you ever tell the police that you wanted to speak to an attorney?
Yes
No

Is it possible that there was drugs/medications in your system?
Yes
No

Were you under any kind of doctors care on the date of your arrest?
Yes
No

Are there any witnesses who were with you before or during your driving that can testify for you?
Yes
No

Do you have any prior injuries, or present disabilities, that might have affected your driving or testing that night/day?
Yes
No

Additional Comments: