Provide basic information on your Georgia DUI case to attorney J. Michael Mullis, The DUI Guy, Georgia DUI lawyer
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DUI Guy Quick Intake
Submit This Form Now Or Call Toll-Free To Talk to a Lawyer Experienced in Georgia's DUI Laws
By J. Michael Mullis, Attorney at Law, The DUI Guy
Georgia DUI Lawyer 1-229-245-0064
Valdosta, Quitman, Adel, Lakeland


Talk To An Experienced
Georgia DUI Lawyer

J. Michael Mullis, The DUI Guy, Georgia DUI lawyer
". . . . I know Georgia DUI law inside and out. . . Let me help you."
                                               
J. Michael Mullis, The DUI Guy

QUESTION:
Why should you complete this form now?

ANSWER:
Because if you don't, you could lose your driver's license before you even go to court for DUI!
 

First Name
Last Name
Address 1
Address 2
City
State
ZIP
Phone #
Okay to call you at this number?
Yes No
Alternate Phone#
Okay to call you at this number?
Yes No
Alternate number is a
FAX
Okay to fax you at this number?
Yes No
Email
We Must Have This To Send You A Reply
Okay to email you at this address?

Yes No
How did you find this web site?

Please specify how you found us, if not listed above.

Date of Arrest
Time of Arrest
Day of the Week
City Where Arrested
County Where Arrested
Court Date (leave blank if unsure)
Time of Court
Name of Court
Driver's License #
State Where Licensed
Date of Birth
Are you currently on probation or parole?

Yes No
If "yes", where?
If "yes", for what offense(s)?

Other Tickets or Charges received with this DUI (check all that apply):

  • Failure to Maintain Lane
  • Speeding
  • Illegal U-Turn
  • Running Red Light or Stop Sign
  • Defective Equipment
  • No Proof of Insurance
  • Failure to Yield
  • Other (Please specify below...)

 

Please specify other charges not listed above

Why were you stopped and arrested, according to the officer?

Was there an accident?
Yes No Not Sure
Was anyone injured? (check all that apply):
  • No one was hurt/Not applicable
  • Myself
  • Passenger(s) in my vehicle
  • Passenger(s) in another vehicle
  • Pedestrian
  • Not Sure

 

Were you stopped at a roadblock?

Yes No

Were you given field sobriety tests at the location where you were stopped?

Yes
No
Don't recall
I Refused

Which field sobriety tests were you given? (Check all that apply)

  • Hand held Breath Test
  • Walking heel to toe
  • One-Leg Stand
  • Follow-the-Pen-With-Eyes
  • Say the Alphabet
  • Touch Your Nose
  • Other (Please specify below...)

 

Please specify other tests you took, that are not listed above

Did officer advise you that field tests were 100% optional and that no penalty would result from not doing them?

Yes No

Were you videotaped at any point during your arrest?

Yes No Not Sure
Did the officer request and did you take a breath, blood, and/or urine test?

Note: If you refused or if the officer wrote you up for refusing, check the NO box and explain in the message box below.

  • Yes
  • No, I Refused
  • Not Sure

 

WARNING: IF YOU WERE CHARGED WITH REFUSING TO TAKE THE STATE TEST, OR IF YOU TOOK THE TEST AND REGISTERED AN UNLAWFUL BLOOD ALCOHOL LEVEL,* YOU ONLY HAVE TEN BUSINESS DAYS FROM THE DATE OF YOUR ARREST TO REQUEST AN ADMINISTRATIVE LICENSE SUSPENSION HEARING.  FAILURE TO DO SO COULD RESULT IN AN ADMINISTRATIVE SUSPENSION OF YOUR DRIVER'S LICENSE FOR UP TO FIVE YEARS, AND THAT'S BEFORE YOU EVEN GO TO COURT!  SUBMIT THIS FORM NOW TO HAVE AN ATTORNEY ASSESS YOUR CASE.

*.08 or above if age 21 or older 
  .04 or above if operating a commercial vehicle
  .02
or above if under age 21


If you took a breath test you should have been given a print-out of the two test samples. List your breath test results here:

   Sample #1
   Sample #2
Blood test results (if known)

Check here if test results are pending
Name of testing officer
Name of arresting officer

Name of police dept.

Did you get your own test of your blood, breath or urine?

Yes No
If "yes", what was the result?

Check here if test results are pending
Additional Comments:



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DUIGUY.COM, Attorney J. Michael Mullis, Georgia DUI lawyer

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