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We can assist you by providing a payment plan and we accept all major credit cards. It is important to contact us early to take advantage of the most flexible payment plans. Our office staff will be happy to give you a preliminary quote and set you with an appointment time which fits your schedule. We strive to provide quick response and answer most email inquiries within 24 hours (weekend inquiries will be called back on Monday). It is helpful if you follow up and confirm email receipt with a telephone call.

Filling out this form and sending it does not create an attorney-client relationship, an attorney will contact you and provide the necessary contract for hire on a case.

Please fill out this form for all general criminal representation. Click here if this is a DWI case.

Or download the form (PDF format). Please fax the form to 505.842.8560

Full Name:
Mailing address:
 
City:
State:
Zip:
Home phone:
Work phone:
Cell phone:
Other phone:
   
Date of birth: (mm/dd/yy)
Social security number:
Drivers license number:
In which state is this Driver's License issued?
Is license a CDL?
Status of your license?
   
Employer:
Job title:
How long have you been employed with this employer? (month, day, years)
Does your employer know about this case?
   
Date of incident: (mm/dd/yy)
Time of incident: (hh:mm)
List crime(s) charged:
Courthouse:
Arresting police agency:
Describe the facts of this incident and arrest:
Do you have medical conditions which relate to the case?
List all prior arrests & convictions (nationwide): (include county, date, crime(s) charged)
Currently on probation or parole?
How did you learn about us?
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What questions do you have?
 

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