Criminal Arrest Form | Attorneys in Dothan

Criminal Arrest Intake Form

Please fill out the following Criminal Arrest intake form in its entirety and click submit at the end. This form will be securely sent to us.

Today's Date *

Full Name * Address *

City *

State *

Zip *

County *

Home Phone

Cell Phone *

Date of Birth *

Age *

Social Security Number *

Employer (if applicable)

Employer Phone

May We contact you at work? *

Email *

Preferred method of contact *

How did you hear about us? *

What type of case do you have? * Please write a brief statement explaining the events surrounding this case * What is your major concern regarding your case? * Arresting Agency: Where were you arrested? Do you have prior convictions? * Upcoming Court Dates: Notes:

Criminal Arrest Intake Form

Criminal Arrest Intake Form

Please fill out the following Criminal Arrest intake form in its entirety and click submit at the end. This form will be securely sent to us.

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