Drunk Driving Free Consultation Form-Colorado Springs DUI Attorney

Colorado Springs DWI Attorney

Please complete this form to receive a free consultation. You will receive a phone call and/or an E-mail very soon.

You may also choose to forego this form and simply call us toll-free at (800) 968-3051.

*Name:
Date of Birth:
Home Phone:
Ok to Call?	Yes No
Work Phone
Ok to Call?	Yes No
Cell Phone:
Ok to Call?	Yes No
Pager Number:
Ok to Call?	Yes No
Date of Alleged Offense:
County Where Charged:
	Blood Test Breath Test Alleged Test
Result of Breath/Blood test, if known:
Were you required to post bond?	Yes No
Next Court Date: Time:
What Court/Location:
Are you a United States Citizen?	Yes No Unsure
If you are not the person charged, what is your relationship?
Is there a different way/ phone number we should use to reach you, please give details.
*E-mail Address:
Ok to E-Mail?	Yes No

Please briefly describe the circumstances of your case. For your protection do not make any admissions of guilt or state anything incriminating - if you are unsure, wait and give the information to us when we call you. Description/Comments:

The use of the Internet for communications with the firm will not establish an attorney-client relationship and messages containing confidential or time-sensitive information should not be sent.

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DANIEL, THOM & KATZMAN, P.C. - LIBERTY LAW CENTER
COLORADO CRIMINAL AND DUI / DWI DEFENSE ATTORNEYS / LAWYERS

Toll Free: 1-877-234-DUI (877-234-4384)

El Paso County - Colorado Springs - Colorado
(Experience Criminal / Drunk Driving ( DUI / DWI ) counsel available in most Colorado Counties)