Drunk Driving/DUI Defense Intake Form

Note: fields with a * are required.

* Name

* Email Address

Phone Number

Address

City

State

Zip

Work Phone

Mobile Phone

Fax/Other

Do you have a court date? Please provide details:

City and county of arrest:

Arresting officer's name and badge number, if known:

Blood-alcohol concentration (BAC) level at time of arrest, if known:

Type of test used to determine BAC, if a test was administered.

Were field sobriety tests given?
Yes   No 

If so, describe tests and results.

What was the specific drunk-driving offense for which you were arrested (include code section, if known)?

Have you been convicted of drunk driving before?
Yes   No 

If yes, please provide details:

Have you been convicted of other offenses?
Yes   No 

If yes, please provide details:

Are you on probation or parole?
Yes   No 

If yes, for what?

Do you have any other cases pending? If yes, please provide details:

Was anyone else arrested in the current incident?
Yes   No 

If yes, please provide the name(s) of all persons arrested:

What statements do you remember making to the police about the alleged drunk driving?

Describe the order of events leading up to the arrest.

Have you discussed the alleged drunk driving with anybody else?
Yes   No 

If yes, with whom and what did you say?

Were there any witnesses to the alleged drunk driving?
Yes   No 

If yes, provide names and contact information if known.

Did you post a bond? If yes, what was the amount of the bond?

Are there any special bond conditions? If yes, please describe the bond conditions.

Do you have any special concerns?

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The Bussey Law Firm, P.C.
12 East Boulder Street
Colorado Springs, CO 80903
P: 719.475.2555
F: 719.475.0046

The law firm of Timothy Bussey represents people in Colorado Springs and the surrounding parts of Colorado, including Manitou Springs, Falcon, Monument, Fountain, Palmer Lake, Pueblo, Cripple Creek, Castle Rock, Woodland Park, Pikes Peak, The Springs, as well as all cities within El Paso County, Teller County, Pueblo County, and Douglas County. We represent civilians as well as military personnel, including those at Fort Carson, Peterson Air Force Base, Cheyenne Mountain Air Station, Schriever Air Force Base, and the U.S. Air Force Academy (USAFA).

Colorado Springs DUI Defense Lawyer Disclaimer: The legal information presented at this site should not be construed to be formal legal advice, nor the formation of a lawyer or attorney client relationship. Any results set forth herein are based upon the facts of that particular case and do not represent a promise or guarantee. Please contact a drunk driving defense attorney for a consultation on your particular legal matter. This web site is not intended to solicit clients for matters outside of the state of Colorado.

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