Leeders & Associates Ltd. DUI Evaluation

Your Information

Name:

Email Address:

Address:

City:

State:

Zip:

(xxx-xxx-xxxx) Phone:

(xxx-xxx-xxxx) Cell Phone:

Is this your first DUI?	Yes No
Did you take a breathalyzer/blood test?	Yes No
Did you take a field sobriety test?	Yes No
What date were you arrested?
What date is your court date?
What county were you arrested in?

Provide brief summary of your situation and the services you are requesting.

Additional Information

Best day and time to contact you:

Where did you hear about us?
The information provided herein will be kept confidential. By submitting an on-line evaluation request you are NOT establishing an attorney client relationship. Leeders & Associates, Ltd. will not represent any applicant nor will we attend any court hearings without first being retained.

For a free consultation, call 312-427-7400 today to speak with an experienced Chicago DUI attorney at Leeders & Associates, Ltd. for a free consultation.

Office Locations:
Loop: 20 E. Jackson Blvd., Ste. 850 Chicago, IL 60604
South Side: 10001 S. Western Ave. Chicago, IL 60643
O'Hare: 8770 W. Bryn Mawr, 13th Fl Chicago, IL 60631
SW Suburbs: 3333 Warrenville Road Ste. 200 Lisle, IL 60532
NW Suburbs: 2025 S. Arlington Heights Rd. Ste. 113 Arlington Heights, IL 60005
Northern Suburbs: 228 N. Genesee, Ste. 205 Waukegan IL 60085

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