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Please specify how you found us
Are you mainly interested in fighting your DWI, or do you want to plead nolo or guilty?
Fight the Case
Plead Nolo
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Date of Arrest
Time of Arrest
Day of the Week
City Where Arrested
Parish Where Arrested
Court Date (leave blank if unsure)
Time of Court
Name of Court
Driver's License Number
State where Licensed
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Alaska
Arizona
Arkansas
California
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Rhode Island
South Carolina
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Tennessee
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Utah
Vermont
Virginia
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Washington
West Virginia
Wisconsin
Wyoming
Date of Birth
Is this your first DWI / DUI in your lifetime -- anywhere, anytime?
Yes
No
If you have had prior DWIs / DUIs please list them below Month / Year -- Court -- Result (Guilty, Not Guilty, Nolo)
Are you currently on probation or parole?
Yes
No
If "yes", where?
If "yes", for what offense(s)?
Other Tickets / Chargest Received with this DWI (check all that apply):
Improper Lane Usage
Speeding
Illegal U-Turn
Running Red Light or Stop Sign
Defective Equipment
No Proof of Insurance
Failure to Yield
Other (please specify)
Other (please specify)
Other (please specify)
Why were you stopped / arrested, according to the officer?
Was there an accident?
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No
Not Sure
Was anyone injured? (check all that apply):
No One Was Hurt / Not Applicable
Myself
Passenger(s) in My Vehicle
Passenger(s) in Another Vehicle
Pedestrian
Not Sure
Were you stopped at a roadblock (DWI checkpoint)?
Yes
No
Don't Know
Were you given field sobriety tests at the location where you were stopped?
Yes
No
Don't Recall
I Refused
Which field sobriety tests were you given? (check all that apply):
Hand Held Breath Test
Walking Heel to Toe
One-Leg Stand
Follow-the-Pen-With-Eyes
Say the Alphabet
Touch Your Nose
Other (please specify)
Other (please specify)
Other (please specify)
Did the officer advise you that field tests were 100% optional and that no penalty would result from not doing them?
Yes
No
Not Sure
Were you videotaped at any point during your arrest?
Yes
No
Not Sure
Did you take breath test?
Yes
No, I Refused
Not Sure
WARNING: If you refused or Failed the breath test, you could face an automatic suspension of your driver's license. You may have only 15 days from the date of your arrest to request a hearing to challenge the suspension of your driving privileges. Call our office immediately for assistance at (985)370-9832.
If you took a breath test you should possess a print-out of your test samples. List your breath test results here: Sample #1
Name of Testing Officer
Name of Arresting Officer
Name of Police Department
Street or Location Where Stopped
Parish Where Stopped
Was Your Car Towed?
Yes
No
Who Authorized the Tow Truck?
I Did
Officer Did
Not Sure
Who Posted Bond?
I Did
Bonding Company
Family Member/Friend
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Amount of Bond
$
Were there any witnesses with you who could testify for you?
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No
If "Yes", Give Names and Contact Info
At any time during your arrest did you ever ask for or inquire about getting your own independent blood test?
Yes
No
Did You Get an Independent Blood, Breath, or Urine Test?
Yes
No
If "Yes", What were the results?
Check here if test results are pending
Did You Ever Ask to Call an Attorney?
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No
If "Yes", when? (give details)
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