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Attorney Intake Form: Getting Arrested

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If you've been arrested, chances are you'll want the help of an attorney who has experience in handling criminal matters. After all, there are many phases of the criminal justice system which can be complicated and which could involve violations of your constitutional rights. An experienced criminal defense lawyer understands the process and can protect those rights.

Not only that, your attorney is your strongest advocate and can help you challenge the prosecution's evidence or even negotiate with the government to obtain a plea bargain in your case. However, in order for your attorney to best represent you, he or she will need to know all of the relevant information about your case and your background. But what's relevant and how will you know what information to provide? After all, an address from 5 years ago may seem unimportant, but it could become relevant in a particular case. For example, former neighbors could be used to provide witness testimony that they saw the weapons used in a crime at a defendant's old address.

Thankfully, there are ways to help you convey relevant information to your attorney, one of which is the use of intake forms, such as the one below. These forms provide you with an idea of the information you may need to provide to your attorney during your first meetings. For example, your attorney will need to know whether you have a criminal record. If so, that information can be relevant to your chances of success at trial and the likelihood of having a particular prison sentence imposed. Other factors, such as your education level and income level, may also play a role in how you are perceived by a jury and in how long you may be imprisoned.

Sample Intake Form

Full Legal Name: _____________________________________

Date of Birth: _______________________

Race/Nationality: ____________________

Social Security Number: __________________

Address:___________________________________________________________
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Length of Time at that Address: _______ years

Previous Address(es) (for last 10 years):___________________________________
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Home Telephone Number: ____________________

Work Telephone Number:____________________

Facsimile Number:____________________

E-mail Address: ____________________

Former Name(s):____________________________

Marital Status: _________________________________

Previous Marriage(s): Yes ____ No ____ Ended By?___________________

Children:

Name/Date of Birth/Living at Home?

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Education:

High School Graduate? __________Yes/No
If Yes:__________________If No:___________________
Year of Graduation/Last Grade Completed ______________

College? _____________Yes/No
If Yes: __________________Major:_____________________
Year of Graduation

Graduate School? _____________Yes/No
If Yes: __________________Degree:____________________
Year of Graduation

Additional Education

History:_______________________________________________________________
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Employer: _____________________________________________________________
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Job

Position/Title:__________________________________________________________

Employer's Address:_____________________________________________________ _____________________________________________________________________
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Length of Time with Employer: _______ years ________months

Previous Employer(s) (for last 10 years):_________________________________________
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Gross Monthly Income from Employment: $_________________

Other Income: _________________________________________________________
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Date of Arrest: _____________________

Time of Arrest: _____________________

Location of Arrest: __________________

Date of Alleged Crime: _______________

Location of Alleged Crime:_________________________________________________
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What was the reason or explanation given for your arrest?____________________________
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Did the police have a warrant? ___________________ Yes/No

What crime were you charged with?____________________________________________
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Who arrested you (name and badge number of officer(s))?____________________________
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Was anyone else present at the time? _____________Yes/No
If Yes, explain:_________________________________________________________
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Was your property searched at the time of the arrest? ________________Yes/No
If Yes, explain: _________________________________________________________
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Did the police find anything that they kept? _____________Yes/No
If Yes, explain: _________________________________________________________
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Were you searched at the time of the arrest? ________________Yes/No
If Yes, explain: _________________________________________________________
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Did the police find anything that they kept? _____________Yes/No
If Yes, explain: _________________________________________________________
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Were you read your Miranda rights (informing you that you have the right to remain silent, you have the right to an attorney, etc.) at the time of your arrest? _____________Yes/No
If Yes, explain:________________________________________________________
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Did you give or sign any statements? _______________Yes/No
If Yes, explain:_________________________________________________________
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If Yes, do you feel the statement was voluntarily given?___________________ Yes/No
Explain: ______________________________________________________________
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Were you asked to participate in a line-up at any time?_________________________

Were you fingerprinted or photographed at any time?______________________________

At any time prior to or after your arrest did you ask to speak to anattorney?_____Yes/No
If Yes, was one provided to you? __________________________________________
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What was the name of the attorney you spoke to?_________________________________
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At any time were you physically threatened or mentally harassed by the police? __Yes/No
If Yes, explain: ________________________________________________________
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What is your version of the events leading up and causing your arrest?
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Do you have a drivers' license? ___________________Yes/No
If Yes, what state issued your license? ____________________
If No, have you ever had a drivers' license? ________________

Explain: ______________________________________________________________
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Do you own any automobiles, motorcycles, or other motorized vehicles?_______Yes/No
If Yes, please list all such vehicles:__________________________________________
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Have you ever owned a firearm? _____________________Yes/No
If Yes, explain:_________________________________________________________
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Have you ever been questioned, but not arrested, in connection with a crime?____Yes/No
If Yes, explain:_________________________________________________________
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Do you have a criminal record? ______________________Yes/No
If Yes, explain:__________________________________________________________
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Are you in good health? ____________________________Yes/No
Explain all current and chronic illnesses, past and future surgeries, and medications you are currently taking, and other relevant health information:_______________________________________
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Do you have a history of alcohol or drug abuse? _____________________Yes/No
If Yes, explain:_____________________________________________________________
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Have you ever been treated by a psychologist, psychiatrist or other mental health care professional? _______________________Yes/No
If Yes, explain:_____________________________________________________________
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Other Important Information:
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Questions to Ask My Attorney:
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Put Your Intake Form To Use With A Free Case Evaluation

Often when you first sit down with an attorney it's hard to know what information is relevant or what questions you should ask. Filling out an intake form ahead of time can help. It's also a great way to make sure that your attorney can review the necessary background information before speaking with you, which can make your meetings more focused and productive. You can get started today by speaking with an experienced criminal defense attorney in your area and even receive a free initial evaluation of your case.

Next Steps
Contact a qualified criminal lawyer to make sure
your rights are protected.
(e.g., Chicago, IL or 60611)

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