Your Future is
Worth Fighting for
Our Team is On
Your Side
Our Team is On Your Side
c-img-new c-img-new c-img-new

Client Intake Form: Dui Case




















    YesNo


    YesNo












    Questionnaire


    YesNo


    YesNo


    YesNo


    YesNo


    YesNo


    YesNo


    YesNo


    YesNo


    YesNo


    It is vitally important and in your best interest that we are aware of ALL past charges so we can adequately assess your situation and properly advise you. Failure to list all prior offenses can drastically affect the advice you will receive and/or the outcome of your case. You do not need to list minor misdemeanors traffic infractions such as speeding, seat belt, red light charges, etc. Do not include the charge(s) you are here on.


    YesNo




    Help Us Improve Our Services





    YesNo


    YesNo





    Your Information Is Secure

    Information supplied in online forms is transmitted securely to Weisenburger Law Offices, LLC using Secure Sockets Layer (SSL). Ensuring that communications remain secure between users and the Web server is a critical issue. SSL is the protocol developed to transmit private information via the Internet. It works by using a public key to encrypt data that is transferred over the SSL connection. The key used for the encryption is contained in the site’s security certificate. This protects your login credentials, addresses, and other secure data. Please see

    Let’s Encrypt

    Information provided to us is protected by the attorney-client privilege, which extends to all of our office staff.
    Any legal advice given is dependent upon the accuracy of the information you provide in this form.
    Please make sure that the information you provide is complete and accurate.