Criminal defense intake form template
Someone searching for a defense attorney at 1 a.m. is in the worst hour of their life, and a long intake form is the last thing they will finish. This flow takes seven one-tap answers, charge, timing, court date, who needs help, representation status, record, state, and gets a case summary to an intake team while the urgency is real.
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Open it on your phone. Links to the live demo funnel, not this page.
What's inside this template
Seven case questions, each answerable in a second, with contact details last. The one-tap cadence is what carries a stressed visitor through, and it is the structure the 34% platform average is measured on.
- 1
Charge type
DUI, drug, assault, theft, or other. Practice areas differ, and the first tap routes the case to the right desk.
engagement_firstconditional_routing - 2
When charged
Just arrested versus weeks ago changes everything about urgency and what can still be done.
intent_capture - 3
Court date status
A date on the calendar is the strongest urgency signal in legal intake, scored accordingly.
buyer_qualification - 4
Who needs help
Self or a family member. Parents and spouses fill this form as often as defendants do, and the script differs.
buyer_qualification - 5
Attorney status
Already represented filters out; searching for representation is the file firms pay for.
buyer_qualification - 6
Prior record and state
Priors shape the defense; state matches the case to a licensed attorney or buyer.
conditional_routing - 7
Contact details, verified
Name, email, and phone close the intake, verified live so the callback happens tonight, not never.
email_verifyphone_verifytcpa_consent
Built to deliver qualified leads
Same ad spend. Capture 2X the qualified leads. Defense firms buy signed cases, not clicks, and the intake answers here, court date, representation status, charge, are what separate a case from a curiosity. Funnels across the platform average a 34% conversion lift on this short-tap structure.
Urgency-ranked case queue
Court-date and arrest-timing answers score each file, so intake calls the hearings-this-week cases first.
Lead scoring →Practice-area routing
Charge type sends DUI files to DUI attorneys and drug cases to the firms that want them.
Distribution & routing →Callbacks that connect
Phone verification at capture matters most when the caller has one chance to reach a scared person.
Lead verification →Legal intake notes
Boundaries the template keeps for you:
- Copy avoids outcome language bar advertising rules restrict
- No case detail beyond category is collected, keeping privileged facts off the form
- Consent above the submit names the firm or service placing the call
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Frequently asked questions
Does the form collect case details?
Only categories, never narratives. What happened stays for the attorney conversation, which protects both the visitor and the firm.
What is a qualified defense lead?
A qualified lead is one with a verified email, a verified phone, enriched data, and a Contact Score above your threshold, checked before the visitor leaves the page. Court-date and representation answers add the case-urgency layer.
Can already-represented visitors be filtered?
Yes. The attorney-status answer can end the flow with a polite resource page instead of billing as a lead.
Does it work for multi-state legal networks?
State selection routes each case to attorneys licensed in that state, one funnel covering the whole network map.
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Start capturing qualified criminal defense leads
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