Criminal Form Criminal Form 5899 Preston Rd, Suite 101, Frisco, Texas 75034.office: 972-370-5060 Date 2025-02-06 Client Information Form (Criminal ) First Name *: Last Name *: Family Name *: Date of Birth Current Age * SSN# * DL# * Current Address: City *: State *: Zip *: County *: Telephone: Home * Cell * Email * Place of Employment *: Work Telephone *: Place of Birth *: Are you a US Citizen? * Please SelectYESNO Educational Background (GED, High School, College, Trade School) *: Served in the Armed Forces? Please SelectYESNO Married?* Please SelectYESNO If you have children, how many? Whom do they live with? Are you currently on any medications? Please explain: Have you ever received mental health or substance abuse counseling? TICKET / CHARGE / CITATION / INDICTMENT / COMPLAINT INFORMATION: Name of Agency: Booking #: Jurisdiction (Municipal, County Court, District Court): Are you arrested? Please SelectYESNO Date of your arrest: Time of your arrest: Location of your arrest: City: State: Zip: County: Individuals present at the time of your arrest: Do you have a court date? When? Have you already seen a Judge? When? Did you post bond? Please SelectYESNO How much? List any special conditions on bond: Have you signed any papers or taken any steps through the court procedure yet? Please explain: Briefly list the facts of your case: Please list ANY RELEVANT INFORMATION TO YOUR CASE – Such as, but not limited to, important witnesses, alibi information, significant documents, and other parties involved: Do you have any other criminal matters pending? If so, please list the name of the court, jurisdiction, case numbers and charges: PRIOR CONVICTIONS / PRIOR ARRESTS Are you currently on probation or parole? If so, please explain: HOW DID YOU HEAR ABOUT OUR PRACTICE? Are you currently on probation or parole? If so, please explain: Internet search/magazine/yellow pages/local directory/referred (if you were referred please indicate by whom)