Meltzer and Bell, PA remains committed to the people of South Florida during this very difficult time. Please know that we are open and will remain so 24 hours a day, seven days a week to those in our community who need our help.

Client Information and Intake Form

Fill out the intake form below or download the intake form document and fill it out manually.



Check all that apply: *











(required)

Have you Received any Tickets in the Last 2 Years? *
Have you have ever been Previously Charged or Sentenced for DUI, Leaving the Scene of an Accident or DWLS? *

*** Only Complete if Cited for Criminal Violations ***

Are you currently on (check all that apply):




Are you out on a Cash Bond?
Are you out on a Surety Bond?

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