Court Duty Solicitor Intake Form
Please complete this form to request assistance from a duty solicitor. Your information will help us provide you with timely legal support.
Full Name
*
First Name
Last Name
Date of Birth
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Preferred Method of Contact
*
Phone
Email
Text Message
Other
Are you currently in custody or at the court?
*
In custody
At the court
Neither
Court Location (if known)
Type of Legal Matter
*
Please Select
Criminal
Family
Civil
Immigration
Other
Brief Description of the Legal Issue
*
Date and Time of Incident or Hearing
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Do you have any special needs or require an interpreter?
No
Yes, I need an interpreter
Yes, I have other special needs
Please specify your language or special needs (if applicable)
Submit Request
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