We request that each of our clients complete an Initial Consultation Form and bring the completed form to the first attorney-client meeting. If you have scheduled a meeting with us to discuss your traffic ticket, please complete the printable form or the online form below. The online form sends the information by email to Wegner Buchanan. If you complete the printable form, please bring the form with you to the first attorney-client meeting.

It is important to understand that you are not a client of Wegner Buchanan until you have signed an engagement agreement and paid the required retainer. You do not become a client of Wegner Buchanan by completing an Initial Consultation Form.

How did you hear about us?
Name:
Gender:	Male Female
Date of Birth:
Social Security Number:
Drivers License Number:
CONTACT INFORMATION
Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Work Phone (optional):
Email Address:
TRAFFIC TICKET
Reason for Stop (speeding, reckless driving, etc.):
Date of ticket and/or arrest:
Ticket/Citation No.:
PLEASE PROVIDE A COPY OF YOUR TICKET/CITATION
SUSPENSIONS
If your case involves a suspended license, please list all known convictions. Please include date (month/year), county, reason for suspension: