Skip to content
206-209-5585
206-858-1380
info@willdefendwa.com
Firm
About Us
Blog
Criminal Defense
Under Investigation
Sex Crimes
Domestic Violence
Vacating Convictions
Theft Crimes
Violent Crimes
Prostitution Stings
Online Minor Sex Stings
Child Pornography
Drug Crimes
DUI
FAQ
Contact
Firm
About Us
Blog
Criminal Defense
Under Investigation
Sex Crimes
Domestic Violence
Vacating Convictions
Theft Crimes
Violent Crimes
Prostitution Stings
Online Minor Sex Stings
Child Pornography
Drug Crimes
DUI
FAQ
Contact
Client Intake Form
Client Intake Form
CLIENT INTAKE FORM
Contact /Personal Information
Today's Date
*
MM slash DD slash YYYY
Name
*
First
Last
Date of Birth
*
Month
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Email
*
Mobile Phone Number
*
Home Phone Number
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Preferred Contact Method
Phone
Email
Text
Any of the Above
Driver License Number
Employer/Position
Length of Employment
Work Phone Number
Case/Background Information
I need an attorney for:
*
Myself
Someone Else
Your Relationship to Accused
Spouse
Significant Other
Parent
Child
Friend
Other Family
Name of Accused
First
Last
Date of Birth of Accused
MM slash DD slash YYYY
Type of Charges(check all that apply)
*
Felony
Gross Misdemeanor
Post Conviction
Misdemeanor
Pre-Filing
I Don't Know
Case Number(if known)
Court Location
Next Court Date
MM slash DD slash YYYY
Time
:
Hours
Minutes
AM
PM
AM/PM
Type of Hearing
Tell us about the case(all answers confidential)
Any prior convictions?
*
Yes
No
If yes, please explain
Additional Contact Person
Name
*
First
Last
Mobile Phone Number
*
Email
Relationship to you
Spouse
Significant Other
Child
Parent
Friend
Other Family
We Need Your Help!
How did you find us?
Referral
Google Search to website (willdefendwa.com)
Avvo
Yelp
Thumbtack
Bing
Other
Δ
