# Criminal Defense Intake Form Template

> A free criminal defense intake form for defense attorneys. Callers share the charge, court date and custody status, and lead mode shows who to call first.

Ask every new inquiry about the charge, where the case is, the next court date and whether the person is in custody, with an upload for the citation or charging papers. Lead mode marks cases with a court date soon as hot leads and flags people who already have a private lawyer.

Canonical: https://reuily.com/templates/criminal-defense-intake-form
Use this template: https://reuily.com/form/from-template/criminal-defense-intake-form
Collections: Marketing & Sales, Requests & Intake, Professional Services, Legal
Last updated: 2026-10-24

## Questions

- Question 1: What's your full name? (Short Text, required)
- Question 2: What's your email address? (Email, required)
- Question 3: What's your phone number? (Phone, required)
- Question 4: Who needs help? (Single Choice, required). Options: Me; A family member; A friend
- Question 5: If it's not you, what's the name of the person charged? (Short Text, optional)
- Question 6: What kind of charge is it? (Single Choice, required). Options: DUI or DWI; Drug charge; Assault or violent crime; Theft or property crime; Domestic violence; Traffic or license; White collar or fraud; Something else
- Question 7: Is it a felony or a misdemeanor? (Single Choice, required). Options: Felony; Misdemeanor; Not sure
- Question 8: Which county and state is the case in? (Short Text, required)
- Question 9: When is the next court date? (Single Choice, required). Options: Within 7 days; Within 30 days; More than 30 days away; No court date yet
- Question 10: Is the person in custody right now? (Yes / No, required)
- Question 11: Do you have a lawyer for this case? (Single Choice, required). Options: No; A public defender; Yes, a private lawyer
- Question 12: Briefly describe what happened (Long Text, required)
- Question 13: Upload the citation or charging papers (File, optional)
- Question 14: When is the best time to call you? (Single Choice, required). Options: Morning; Afternoon; Evening

## Common uses

- Criminal defense firms
- DUI and drug charge inquiries
- Calls from family members

## Key features

- Charge, court date and custody
- Citation uploads
- Hot leads for court dates within 30 days

## Frequently asked questions

### What should a criminal defense intake form include?

The charge, whether it is a felony or misdemeanor, where the case is, the next court date, custody status and current representation. Leave the full story for the first call.

### Can family members fill this in?

Yes. The form asks who needs help and the name of the person charged, so a parent or partner can reach out for someone in custody.

### How does lead mode rank defense cases?

Cases with a court date in the next 30 days or a person in custody come through as hot leads. People who already have a private lawyer are marked not a fit.