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Areas of Practice

DWI Law

DUI Tests

NOTE: An asterisk (*) indicates REQUIRED information. The use of the Internet or this form for communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Confidential or time-sensitive information should not be sent through this form.

Name:
Phone Number:
Email:
Arrest Date and Time:
Reason for Stop or Arrest::	DUI/DWI Driving While Suspended/Revoked Speeding Stop Sign / Stop Light Drug Charge Criminal Charge Other
Officer's Stated Reason for stop:
Was there an accident?	Yes No
Injuries?	Yes No
Tests Performed:	Eye Test Walk & Turn Test One Leg Stand Test Alphabet Test Numbers Test Finger to Nose Test Finger Counting Test Other Tests
Did You Submit to:	Breath Test on the Road Breath Test at the Station Blood Test Urine Test REFUSED One of These Tests
Test Result: (example .135)
Was Your License Taken?	Yes No
Type of License:	Standard Limousine Motorcycle CDL
Do You Wish to Fight for Your License to..	Work Travel to School Drive Children or Other Family Members Other
How Many Prior DUI/DWIs?	None One Two or More
Do You Have Any Current or Prior Injuries to:	Back Feet Knees Other
Court Date and Time:
Court Location:
Comments

Licensed in Kansas and Missouri · Free initial consultation · Upfront pricing
Visa / MasterCard accepted · Flexible office hours

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Paul W. Burmaster, P.A. 8000 Foster Street Overland Park, KS 66204 | Email | Directions

Burmaster Law Firm - Overland Park, KS - Serving drivers throughout the Kansas City metro area, including residents of Leawood, Prairie Village, Lenexa, Olathe, Shawnee, Lawrence, Merriam, Lee's Summit, and Independence, and of the communities in Johnson County, Leavenworth County, Wyandotte County, Jackson County, Douglas County, Franklin County, Clay County, Cass County, and Miami County.

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