Drunk Driving Defense Interview

Name: * 

Your Home Address: * 

Date of Birth:   

Driver License Number:   

State Where Licensed:   

Do you currently have a Commercial Driver's License?

yes

no

Email Address: * 

Please indicate any restrictions on phone calls:

Home Phone: * 

Business Phone:   

Cell Phone:   

Facsimile Number:   

Contact Preference (how do you want to be contacted, i.e. be discrete, email, etc.)?   

Occupation:   

Place of Employment:   

Annual Income:   

Is it your goal to win your DWI case?

yes

no

Date of Your Current Arrest?   

For Texas, scheduled to appear in which County?   

What date and time is your court date?   

Have you ever been arrested for DUI/DWI before?

yes

no

 

If you have had prior DWIs please list them below. Please include month/year, court, & court results.
  

Are you currently on probation or parole?

yes

no

 

Please check below all other tickets/charges received with this DWI:

  SpeedingIllegal U-turnRunning red lightDefective equipment Careless DrivingFailure to yield Other (Please specify below)

If 'Other', please indicate type of charge?

What did the officer indicate to you as the reason for the traffic stop or contact with you (check all that apply)?

  SpeedingWeavingInvolved in accident - no injury to anyoneInvolved in accident - injury to at least one personRoadblock / checkpointUnkownS/he didn't tell me

If none of the above apply, please indicate the reason for the stop of your vehicle or contact with you?

Did the officer see you driving, or if s/he did not, did you admit to driving a vehicle?

yes

no

I don't know/not applicable

Was there an accident?

yes

no

Not sure.

Was anyone injured? (check all that apply):

No one was hurt/Not applicable   Myself   Passengers(s) in my vehicle   Passenger(s) in another vehicle    Pedestrian.    Not sure.

Did you drink any alcoholic beverages, and/or take any drugs, within 10 hours of being stopped by the officer?

yes

no

I don't know/not applicable

If you drank alcoholic beverages, what type (highlight all that apply)?

  None consumedBeer-regularBeer-microbrewBeer-malt liquorWine-redGinVodkaRumTequilaMartiniLong island ice teaOther

If 'Other', please indicate type of beverage?   

Think about the drinks you had. Many people underestimate how many drinks they had, or cannot remember. This can be extremely important to your case though. In order to calculate your Blood Alcohol Level please indicate how many drinks you had total (one drink is equal to a 12 ounce beer, a regular 4 ounce glass of wine, or, 1 shot or 1 ½ ounces-of hard liquor)?

Number of servings of alcohol:   

Approximately what time did you finish your LAST alcoholic beverage?   

If you were on prescription medications or other drugs, what type (highlight all that apply)?

  Not applicableAnti-depressantPain medicationValium/tranquilizerMarijuanaMethamphetaminePowdered cocaine'Crack' cocaineHeroinEcstasyOther

If 'Other', please indicate type of medication or drug?

Did you take any field balance/coordination (field sobriety tests - FST's) tests prior to being arrested and handcuffed?

yes

no

I don't know/not applicable

Refused

Were you ordered or did you do them voluntarily?

Ordered

Voluntary

Please select the field sobriety tests you were ordered to perform (check all that apply)?   Did not take any field testsFollow a pen, finger, or other object with your eyesStanding with my head titled back and eyes closed, feet togetherStanding on one foot for a period of timePatting your hands togetherCounting on your fingersSaying or writing the ABC'sWalking a straight line, or heel-to-toeTouching your nose with fingerOther

If 'Other', please indicate what they made you do?

Did the officer advise you that tests were 100% optional and that no penalty would result from not doing them?

yes

no

Did you fail to satisfactorily perform the balance and coordination tests as demonstrated to you by the officer?

yes

no

I don't know/not applicable

Did you blow into a field breathalyzer or hand-held type gadget?

yes

no

If you know, what was the result of the hand-held breathalyzer gadget test?   

Did the officer advise you that you could refuse to take the hand-held gadget breath test?

yes

no

I don't know/not applicable

Did you take a blood, breath or urine test?

yes

no

I don't know/not applicable

If you took a chemical test, did you take a blood, breath, or urine test?

Blood

Breath

Urine

I don't know/not applicable

Did you take the chemical test (blood, breath or urine at the station) within 2 hours of driving?

yes

no

I don't know/not applicable

Did you select (choose for yourself) the chemical test if you took at least one (i.e. the blood, breath, or urine test)?

yes

no

I don't know/not applicable

If 'yes' type in the test and the results if you know:   

If you are charged with refusing a chemical test, where or when did you supposedly refuse?   Not SelectedI took the chemical testS/he told me I would have my license suspended if I refused, and I refused anyway.I refused during the initial vehicle stop or contact with the cop.I refused when they handcuffed me.I refused in the patrol car.I resused in the patrol car, on the ride to the chemical test location.I refused at the chemical test location.I refused everything from the beginning.I refused when he first stopped me.I refused when we were doing the field tests.I refused when at the station, but he didn't tell me I would loose my license if I refused.S/he told me I could refuse the test when he used a hand-held breathalyzer, so I did.S/he never told me I had to take a test and he didn't tell me I would loose my license for refusing.
 

If you refused, but later changed your mind, please give details:
  

What type of law enforcement officer was the arresting officer (the one who gave you tests, handcuffed you, took you to jail)?
  Not SelectedHighway Patrolman/TrooperLocal Sheriff DeputyCity Police OfficerOther Law Enforcement Officer

Please input the arresting officer's last name and badge or serial number:   

Please input the testing officer's last name and badge or serial number:   

Please input the agency that the officer worked for (ie. Austin Police Department):   

Did the officer treat you fairly and professionally?

yes

no

Please enter any comments about the officer below:
  

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