Contact information: Clients Contact and Biographical Information

Prefix

First name *

Middle name

Last name *

Date of birth

Emails

Email Address *

Type

Upon submission, a copy of this form will be sent to the primary email.

Add email

Addresses

Street address

Country

City

State/Region

Zip/Postal code

Address type

Add address

Phone numbers

Phone number

Type

Add phone number

Tell Us About Your Case

Please answer the following questions to help us understand the type of charges you're facing. This helps us determine how we can best assist you, whether any special legal considerations apply, or if you are eligible for the relief you seek. *All information provide in this survey is confidential and submitted directly to MSC Law.

Please briefly describe the type of legal assistance you are seeking.

Select any of the following that that apply to charges you are currently facing.

(Please select the options that best apply to your current charges. You may select more than one.)

Drug Offense (e.g., possession, delivery, manufacture of a controlled substance)?

Assault (including simple assault, aggravated assault, or assault involving dating, roommates, or family)?

Driving While Intoxicated (DWI) or Driving Under the Influence (DUI)?

Theft (including shoplifting, burglary, robbery, or fraud)?

Sex offense (e.g., indecent exposure, sexual assault, solicitation, etc.)?

Class "C" Ticket

Juvenile Charges

School Disciplinary Issues

Other

Arrest Information

Briefly describe the allegations surrounding the current charges/arrest.

Have you made any statements to anyone (including law enforcement)?

Yes.

No.

Use this area to describe anything else you wish for us to consider.

Bond Information

Have you been released on bond?

Yes.

No.

Past Charges

We ask about any past charges or convictions because they can affect how your current case is handled in court. This helps us give you accurate legal advice and understand your options. Your answers will stay private and are only used to help you.

Do you have prior criminal history?

No.

Yes.

I'm unsure.

Students

We understand that legal issues can create serious challenges for students. Please let us know if you’re worried about how this situation could impact your education, financial aid, or career plans. This helps us support you better and prioritize what matters most right now.

Are you currently a student?

Yes - Higher Education.

I am seeking assistance for a minor who is still enrolled in K-12 school. *Juvenile*

Not currently, but looking to enroll in the future.

Explain any other particular needs regarding school related matters:

Financial Aid or Scholarship Consequences Admissions or Academic Standing Disciplinary Proceedings Student Housing or Loss of Other Student Benefits Impact on Extracurricular Activities/UIL/Sports Immigration Concerns (e.g., visas/international student status) Concerns Related to Graduation Other:

Protecting Your Career

If you have or are applying for a license to work in a field like healthcare, education, law, driving, or skilled trades, even a minor legal issue can affect your ability to keep working. We ask these questions to help protect your license and guide you through options that won’t risk your livelihood.

What type of license do you currently hold or intend to pursue?

Medical License (MD, PA, RN, LVN, etc.)Legal License (law student, JD graduate, or licensed attorney)CDL (Commercial Driver's License)Teaching CredentialBartender or TABC CertificationReal Estate LicenseCosmetology LicenseOther

Please describe any other licensing related concerns (e.g., exposure to restrictions on gun rights):

Military Service

If you’ve served in the U.S. Armed Forces, we’d like to know more about your service. This information can be important in understanding your case and identifying resources or benefits you may qualify for.

Have you ever served in the U.S. military?

Yes

Primary Case Resolution Goals

People approach criminal cases differently depending on their goals, finances, and life circumstances. Your answer helps us plan the best next steps for you.

Which of the following best describes how you want to move forward?

I want to avoid a conviction if at all possible — I’m willing to fight the charge for a dismissal, reduction, or win at trial.

I’m not sure yet. I want to understand my options before deciding.

It depends on the consequences (e.g., record, immigration, school, job).

Other.

Pressing Deadlines or Court Hearings.

Some legal situations come with deadlines, court settings, or emergencies that can’t wait — and missing them can seriously hurt your case. If you have any time-sensitive concerns, it’s important that you let us know right away so we can respond quickly and protect your rights.

Please tell us if any of the following apply:

I have a court date or deadline coming up soon.I’ve been ordered to take action (e.g., hire an attorney, take classes, comply with bond conditions).I may be arrested and would like advice.I’m at risk of being kicked out of school, losing my job, license, or housing.I have a safety concern or urgent personal situation (health, family, etc.).None.