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About
About CPCS
Committee & Senior Management
Press Office
Contact Us
Private Panel Opportunities
Employment
Benefits
Practice Areas
Public Defender Division
Youth Advocacy Division
Mental Health Litigation Division
Children and Family Law Division
Private Counsel Division
Social Work and Social Services
Specialized Programs
Ed Law
Family Justice Advocates
Innocence Program
Immigration Impact Unit
For Clients
Directory
File a Complaint
Client Resources
Attorney & Vendor Resources
Hiring and Membership
Counsel & Vendor Billing
Assigned Counsel Manual
Public Service Loan Forgiveness
Training Department
Wellness Corner
Audit & Oversight
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Brockton Regional Wellness Chat
June 4
@
1:00 pm
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2:00 pm
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Guardianship Roundtable presented by Laura Sanford
MHLD Racial Bias/Cultural Competence Group.
Breathalyzer Case Inquiry Form
Breathalyzer Case Inquiry Form
Defendant Name
(Required)
First
Last
Date of Birth
MM slash DD slash YYYY
Contact person (if you are not defendant)
Defendant Phone Number
(Required)
Defendant Email Address
Defendant Mailing Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Docket Number
Court where case was resolved
Are you on probation?
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Yes
No
Plea or Trial attorney name
Client comments or concerns
How many people live in your household?
Do you receive Transitional Aid to families with Dependent Children(TAFDC)?
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No
Do you receive Emergency Aid to the Elderly, Disabled or Children(EAEDC)?
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No
Do you receive Massachusetts Veterans Benefits Programs?
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No
Do you receive Medicaid (MassHealth), Supplemental Security Income(SSI)?
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No
Are you currently employed full-time?
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No
Were you represented by court-appointed counsel within the last three years (in your OUI or any other matter)?
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Yes
No
Drug Lab Case Inquiry Form
Defendant Name
(Required)
First
Last
Date of Birth
MM slash DD slash YYYY
Contact person (if you are not defendant)
Defendant Phone Number
(Required)
Defendant Email Address
Defendant Mailing Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Docket Number
Court where case was resolved
Are you on probation?
Select
Yes
No
Client comments or concerns
GPS Monitoring Inquiry Form
Your Name
(Required)
First
Last
Contact Telephone Number
(Required)
Contact Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Contact Email Address
(Required)
Criminal Case Number
Court in Which Your Case Was Decided
Name of Attorney Who Previously Represented You in Your Case
Court of Supervision
What is Your Present Source of Income?
MH Hospital Admission Contact Form
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