Free Evaluation

This form takes approximately 10 minutes to answer all of the questions. It is the quickest way for us to look at the detailed information about you, your situation, and the best way to help us evaluate what your options are. Once completed, if you do not hear from my office within 24 hours, please call us at 770-455-1350 to follow up with your status. Is your situation extremely time sensitive? Call us now.


Questions with an * are required.

Your Name *

Your Email *

Phone Number *

Address

City / Zip Code


10 Day Rule Questionaire (Required).
KEEP YOUR LICENSE! FILL THIS OUT NOW!

Date of Arrest *

Did you refuse to take a Blood Alcohol Test (BAC) test? * (A breathalizer or blood test of any sort)
YesNo

Did you try to take the test but they said you refused? *
YesNo

Did you score at or above a 0.08? *
YesNo

Were you under 21 and scored at or above a 0.02? *
YesNo

Did you have a CDL, were in your work vehicle and scored at or above a 0.04? *
YesNo

Are you not sure what you blood alcohol level was? *
YesNo

Did you get a yellow piece of paper 8 1/2 inches by 11 inches entitled Sworn Report of the Arresting
Officer? *

YesNo

Are you not sure what you blood alcohol level was? *
YesNo

If you answered YES to any of these questions, you need to contact me immediately to save your license. Call now at 770-455-1350.


Free Evaluation

Drivers License Issuing State

Drivers License Number

Full Name of Court

Tickets and Other Citations Received with the current DUI

Arresting Officers Name

Type of Officer

Was it a DUI Task Force Officer?

Number of Prior DUI's

Month and Year of 1st DUI (or skip this)

Month and Year of 2nd DUI (or skip this)

Month and Year of 3rd DUI (or skip this)

Anything else you would like to say?

Please type these letters in below: captcha