Attorney Russell J Matson
44 Adams Street, Suite 5, Braintree MA 02184
Telephone: (781) 380-7730
e-mail:

For a free consultation on your OUI charge, contact me via this form or call my office to speak with me or my associate, Henry Fasoldt.

Please complete this form to the best of your ability. This is my detailed form that I use in preparing to fight DUI charges. Your answers to these questions will be a primary source of information that we will use to challenge the state's case against you.

Please be completely honest. If you leave something out, it could impede my ability to determine winning defenses or arguments. Time may be an important factor in your case, especially in cases where medical records are to be used. Failure to return and disclose medical information promptly may result in delay or loss of the ability to use of such records in your defense.

All personal data will be kept strictly confidential.  

Thank you,

Attorney Russell Matson
 

Your Personal Info:
Title:	--None--Mr.Ms.Mrs.Dr.Prof.
First Name:
Last Name:
Email:
Phone:
Mobile Phone:
Fax:
Street Address:
City:
State:
Zip:
Drivers License State
Any License Restrictions?
Do you have a CDL ?	--None--No Yes
Arrest & Court Info:
Police Dept:
Arrest Date:
OUI Offense	--None--1st 2nd 3rd 4th 5th or more
Breath Test?	--None--Refused Failed Passed Blood test Not asked Other
Result, if taken (e.g. .08):
District Court:	--None--Attleboro Ayer Barnstable Boston Municipal Brockton Brookline Cambridge Charlestown Chelsea Chicopee Clinton Concord Dedham Dorchester Dudley East Boston East Brookfield Edgartown Fall River Falmouth Fitchburg Framingham Gardner Gloucester Greenfield Hadley Haverhill Hingham Holyoke Ipswich Lawrence Leominster Lowell Lynn Malden Marlborough Milford Nantucket Natick New Bedford Newburyport Newton Northampton Northern Berkshire Orange Orleans Palmer Peabody Pittsfield Plymouth Quincy Salem Somerville South Boston Southern Berkshire Springfield Stoughton Taunton Uxbridge Waltham Ware Wareham Westborough Westfield West Roxbury Winchendon Woburn Worcester Wrentham
Arraignment Date:
Judge at Arraignment:
Upcoming Pre-trial date:
Employment Issues
Occupation:
Please list any employment issues below, such as: Are there any problems with your present employment? Is a vehicle required for your employment? Would you be fired, restricted in duties, passed over for promotion or demoted: (a) If convicted of DUI? (b) If your license is suspended? (c) If suspended, but you had a "work permit"? Do you drive a company-owned vehicle? Does your company's insurance carrier insure you? Would you be able to function for 6 months or more without driving? Is public transportation readily available to you? What are the possibilities that you could relocate to another state (IF ABSOLUTELY NECESSARY) to protect your right to drive? Do you have "security clearance" issues at work?
Employment Issues Details:
Health Issues
What are your general health conditions? List any current or past conditions that might affect your balance or coordination. List any current of past problems with your arms, legs, knees, ankles or feet. IMPORTANT! If you have any such conditions, please list the doctors or hospitals that provided your care, addresses & phone numbers. Any physical disabilities or prior surgery? Any prescribed medication taken by you daily or periodically? If so, what? Any non-prescription medicine taken by you daily or periodically? Specific health problems? Do you wear dentures or bridgework? If so describe: Do you have any stomach disorders such as acid reflux or GERD?
Health Issues Details:
Other Negative Effects of a Possible Conviction
What effect would a conviction have on you personally? Would a conviction affect your marriage (relationship)? Do you ever have to "prove" insurability in order to drive a "company" car? Do you ever need to rent a rental car, for personal or business use? If "Yes", if you were convicted of DUI or if your license was suspended, would denial of access to rental cars affect you or your business? If so, explain: In what ways would a DUI conviction or license suspension affect your employment or professional standing? Explain: Are you involved in any "domestic" (divorce, child custody, etc.) case or judicial dispute that a DUI conviction or license suspension might affect? If so, explain: Are you in the United States on any type of Visa or temporary work permit status? If so, give details: Do you ever need to travel outside the continental United States, such that any limitation from a DUI conviction could affect you?
Other Effects Details:
Other Attorneys
Have you consulted with any other attorney(s) about your present OUI case? If so, with whom? Have you either hired another attorney or paid a partial fee to another attorney? What advice (regarding a possible plea or about challenging this case) were you given by such other attorney(s)? Do you understand that you are free to follow that attorney's advice (or any other attorney's advice), and that you are in no way bound to use my legal services in your case unless you hire me?
Attorney Details:
Are there any other facts about your case that you feel are important?