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OUI Evaluation Form

Please use the form below to submit your case information. We will get back to you shortly.

First Name: *	A value is required.
Last Name: *	A value is required.
E-mail: *	A value is required.Invalid format.
Phone: *	A value is required.Invalid format.
City and State where the alleged offense occurred:
Time and date when the alleged offense occurred:
The name of the arresting police department (town police or state police):
Was there an accident involved in the arrest? Yes No
Were you alone in the car? Yes - I was alone No - I was with passenger(s)
Did you submit to field sobriety tests? Yes No
Did you submit to a breath test: Yes No
Information you would like for us to know about the alleged offense:

Attorney Christopher A. Shannon