The Gray Law Firm, PLLC

:: Criminal Questionnaire

Felonies DWI/DUI Expungement Drug Offenses Misdemeanors

Name	:
Address	:
Telephone Number	:
Email	:
How did you find this website?	:
Date of Arrest	:
Police Department or law enforcement agency that arrested you	:
Court date	:
Name of Court	:
Charge	:
If a Felony, have you been indicted?	:	Yes No
Prior convictions	:
If you were arrested for DWI
How many drinks did you have?	:
What type of alcoholic drinks did you have?	:
Over what period of time did you consume those drinks?	:
What did you eat the day of your arrest?	:
To your knowledge, why were you pulled over?	:
Was there an accident?	:
Was anyone injured?	:
Did you take a breath or blood test? If so, what were the results?	:
Other comments	: