If you have been arrested for a DWI/DUI in the Columbia, Florence, Myrtle Beach, Conway, Surfside Beach, Loris, Aynor, Georgetown, Garden City, Sumter, South Carolina area, you may be thinking some or all of the following:

• Don’t think the police treated you fair and honestly?
• Not sure why you were arrested?
• Don't think you were intoxicated?
• Feel like the police took advantage of you?
• Wonder why you were even arrested?
• Not sure what is going to happen next?
• Feel like the police didn’t give you a fair chance?
• Confused?
• Scared?
• Humiliated?

Please complete our DUI/DWI form below and let the DUI Lawyers at Coastal Law start the process of protecting your rights.

Enter your Name:                       Enter your Address:

City:                                          State:        Zip Code:

Phone:                                      E-mail:

Date of Arrest:                           Time of Arrest:

Arrested in What State:               What County:

Court Date - (If you know it)       Court Time:

Date of Birth:                            Licensed in What State:

Any Previous DUIs?   Yes   No

If you have had DUIs before, please list them below:

    Date - Which Court - Result (Guilty, Not Guilty or Nolo)

Any other Charges? If yes, please list below:

Was there an accident?        Yes No

If Yes, were there injuries?    Yes No

Was there a Road block?        Yes No

Was a Sobriety test Given?     Yes No

Did you take a Breath Test?    Yes No

Was there a Blood Test?         Yes No

What were the Results of the Breath Test?

What were the results of the Blood Test? 

Name of Arresting Officer:

Name of Testing Officer: 

Name of Police Department:

Was there anyone that could testify for you?       Yes No

Did you at any time ask to speak  to an Attorney: Yes No

If yes give details below: