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Have you or a loved one been injured in the last 3 years?

Yes No

What was the cause of the injury?

Car Accident Motorcycle Accident Truck Accident Work Related Injury Medical Malpractice

When did you injury happen?

less than 12 months ago 1-2 years ago 2-3 years ago 3-4 years ago 5 or more years ago

Were you at fault for the accident?

No, another person was at fault Yes, I was cited or caused the accident Yes, but it was the result of an animal, inanimate object or act of nature

Did the injury require hospitalization, medical treatment, surgery or cause you to miss work?

Yes No

Do you have an attorney working your case?

Yes No

Briefly describe the accident and your injuries

Please enter a brief description of your accident (min 5 characters)

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What is your address?

Street Address

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City

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Are you currently being charged with a DUI?

Yes No

What year did your DUI occur?

less than 12 months ago 1-2 years ago 2-3 years ago 3-4 years ago 5 or more years ago

Are you working with an attorney to reduce your DUI charge?

Yes No

Please give us a brief description of your DUI below

Please enter a brief description of your DUI (min 5 characters)

Having legal support for a DUI can help save your driver's license from being suspended, get a charge reduced or dismissed, and even negotiate away a random drug test or other probation conditions. Would you be willing to pay for DUI support?

Absolutely Probably Maybe No thanks, I want to accept my DUI charges

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Have you or a loved one been injured in the last 3 years?

What was the cause of the injury?

When did you injury happen?

Were you at fault for the accident?

Did the injury require hospitalization, medical treatment, surgery or cause you to miss work?

Do you have an attorney working your case?

Briefly describe the accident and your injuries

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What is your address?

Are you currently being charged with a DUI?

What year did your DUI occur?

Are you working with an attorney to reduce your DUI charge?

Please give us a brief description of your DUI below

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+1-877-243-4032

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