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702-366-0891 Free Consultation
8:00 am - 5:00 pm Available Hours Mon.-Fri.

DUI Questionnaire

If you do not forward this information to our office, be prepared to give this information over the phone.

Arrest Information

Date of arrest:
Time of arrest:
City and state of arrest:
Exact location of arrest ( i.e. intersection of Sahara and Las Vegas Blvd )
Arresting agency:
Why were you stopped?
Do you have any physical limitations that would hinder your ability to take the field sobriety tests?
How do you feel you did on these tests? Please elaborate.
Which field sobriety tests did you take? Please check all that apply.
Did you take a blood or breath test, or did you refuse all chemical testing? Please check all that apply.Blood TestBreath Test On SceneBreath Test Other LocationRefused All Tests Except Breath On SceneRefused All Tests
What were the results of these tests?
Were you advised that you had a right to refuse the breath test?
Were you advised that if you refused that you would lose your license for period of time if you had priors?
Were you advised that there was mandatory jail time if you refused and were convicted?
Were you advised that your refusal could be used against you in court?
Did the officer confuse you in any way?
What county and court is your case in?
When are you to appear?
Have you ever been arrested for any other alcohol or drug offenses?
Valid Nevada Driver’s License Number
Out-of-State Driver’s License Number
Confiscated License?
Was your vehicle impounded?
Did you post bail?
Bail Amount

Biographical Information

What is your name?
What is your address?
List the phone numbers where you can be contacted.
Can messages be left at these numbers?
What is your email address?
License necessary for employment?


In addition to clicking the "Submit" button above, please copy and paste this information in an e-mail to
The Law Office of Garrett T. Ogata

Call (702) 366-0891 for a free consultation.

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