Contact Form Drug Charges PC

*First Name

*Last Name

*Email Address

*Phone Number


Street Address


Incident Street Address

Incident Apt/Ste

*Incident Zip

Business Phone

Cellular or Pager

Booking #

Driver's License #

Court Date


Court Name


Arresting Officer's Name and Badge

City of Arrest

What specific drug offense were you arrested for (include Code/statute section, if known)?

Have you been convicted of a drug violation before?

If yes, when?

Describe the circumstances of the past drug violation and your sentence, if any

Have you been convicted of other offenses?

If yes, what and when?

Have you been through drug treatment in the past?

Are you on probation or parole?

For what?

Do you have any other cases pending?

Was anyone else arrested?

If so, name(s) of all persons arrested

What statements do you remember making to the police about the alleged drug offense?

Describe the order of events leading up to the arrest

Have you discussed the alleged drug offense with anybody else?

If so, whom did you discuss it with and what did you tell them?

Were there any witnesses to the alleged offense?

If yes, provide names and contact information if known

What is the amount of the bond you posted?

Are there any special bond conditions?

Were you referred by somebody else?


Special concerns

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