Criminal Law Consultation Request

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Use this simple form to provide us with information that will help us prepare for your free consultation.

Note: * indicates a required field.

PERSONAL INFORMATION

Name* (First and Last):

Date of Birth (yyyy/mm/dd):

Address: City, Province, Postal Code:

Phone Number*:
May we leave a message at this number? YES NO

Email address:

CASE INFORMATION

Briefly explain what you may need advice or assistance with.*

Do you have a court date? Where is it and when?

Briefly explain any prior criminal record, arrests, convictions, dates and charges.

Were you arrested? YES NO

Were any recorded or written statements given or signed by you during this incident?

YES NO

OTHER DETAILS

Are you completing this form on behalf of someone else? YES NO

How do you intent to pay for fees in this matter?

Cheque
Credit Card
Money Order
Cash
Payment Plan
Legal Aid Certificate

Please tell us how you found our website.

IMPORTANT NOTE

Your submission of this form will not create a lawyer-client relationship and as such will not necessarily be treated as privileged or confidential.

Communicating over the Internet and by e-mail is not always secure, and as such you should not send confidential information via this form.

We assume no liability for any loss or damage you may suffer in consequence of the interception, alteration or misuse of information transmitted over the Internet or from your use of this website.