Diamond, Burt, & Akhkashian -- Los Angeles and California Lawyers & Attorneys

Diamond, Burt, & Akhkashian Case Evaluation Form

Please answer as many of the following questions as you can.

Name:
Email Address:
Street Address:
City:
State:
Zip Code:
Home Phone Number:
Work Phone Number:
Contact Notes:
How did you find us?
Client Information:
Client Name
Date of Birth	/ / mo/day/year
U.S. Citizen
Drivers License #:
-- For Criminal Law Only --
Arrested?
Arrest Date (If applicable)	/ / mo/day/year
Case Number
Booking Number
What Court?
Next Court Date	/ / mo/day/year
Case Information:
Area of Law
Case Facts:
Statement of Case
What GOALS do you have for your attorney?
Additional Comments