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DUI Issue For Women

Tell Us What Happened

The information below is for your records only. It is imperative that you record your account of the arrest, while the event is fresh in your mind. Upon completing this form, you will have the option to forward it to our office. We will need this information prior to your initial consultation. If you do not forward this information to our office, be prepared to give this information over the phone.

  Arrest Information

Date of arrest:
Time of arrest:
City and state of arrest:
Exact location of arrest (i.e. intersection of St. Ann's and PCH):
Arresting agency:
Tell Us What Happened
When stopped, how much time had elapsed since your last drink?
List each drink and the approximate time you consumed it.
List any food and the approximate time you consumed it.
Do you have anything physically wrong with you that would hinder your ability to take the field sobriety tests?

Which field sobriety tests did you take? Please check all that apply.
Alcohol Gaze Nystagmus
Standing on One Foot – Balance
Walking Imaginary Line
Finger Counting
Alternate Clapping
How do you feel you did on these tests? Please elaborate.
Did you take a blood, breath or urine test, or did you refuse all chemical testing? Please check all that apply.
Blood test
Breath test on a small hand-held device at the scene
Breath test at the police station or other location
Refused all but the breath test at the scene
Refused all tests
What were the results of these tests?
Were you advised that you had a right to refuse the breath test?
Were you advised that if you refused that you would lose your license for 1 or 2 if you had priors?
Were you advised that there was mandatory jail time if you refused and were convicted?
Were you advised that your refusal could be used against you in court?
Did the officer confuse you in any way?
Were you given a pink document called "NOTICE OF SUSPENSION/TEMPORARY DRIVER'S LICENSE", or similar words?
What county and court is your case in?
When are you to appear?
List all Prior Drug/Alcohol Offenses
Tells Us Your Concerns

  Biographical Information

What is your name? (Required)
What is your address?
List the phone numbers where you can be contacted.
Can messages be left at these numbers?
What is you email address? (Required)


In addition to clicking the "Submit Query" button below, please copy and paste this information in an e-mail to

Call (949) 497-1729 for a free consultation.


Lawyers Court
260 St. Anns Drive
Laguna Beach, CA 92651

Phone: (949) 497-1729

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