• Intake Form

    Protests Los Angeles : George Floyd Solidarity Protests

  • You may have deadlines or other relevant issues that impact your potential claims, if any exist, as this form creates no agreement or obligation for representation, such deadlines are solely your responsibility and you may need to consult an attorney. 

    Any information that you provide in this Form is private and will be held in the strictest confidence, except as needed by the Parties and the Court. It will not be provided to any Government Agency other than the Defendant. Most of the information requested is already in the possession of the Defendant through your arrest record for this protest. The information provided will be used solely for purposes of this litigation.

    If you have any questions regarding the foregoing or the intake process, please reach out to us directly at protestslosangeles@gmail.com

  • Date of Intake:*
     - -

  • Basic information (1 of 6)

  • Preferred Gender Pronouns
  • Date of Birth*
     - -
  • Format: (000) 000-0000.
  • What is your immigration status?*

  • Information about arrest and citation (2 of 6)

  • Were you arrested ?*
  • Have you been arrested before this arrest?
  • Were you arrested for a curfew violation?
  • Were you were advised or told about the curfew prior to arrest?
  • Citation Date
     - -
  • Court Date
     - -
  • Were others arrested with you?*

  • Police crowd management (3 of 6)

  • Was there a dispersal order (police announce to protesters that there has been an unlawful assembly declared and that the protesters need to vacate a specific area within a specific amount of time)?
  • Please check all that apply:
  • Did the police surround the group from one or more sides in an attempt to push the group?
  • Were people free to leave the area if they wanted to?
  • Did the police proceed to arrest protestors one-by-one?

  • Handcuffs and conditions of confinement (4 of 6)

    For purposes of this form, "handcuffs" includes both metal and plastic handcuffs (aka zip-ties or flexi-cuffs).
  • Were you put in handcuffs?
  • Where were your handcuffs?
  • Where the cuffs metal or plastic?
  • Until
  • Did you ask the police officer to loosen the handcuffs?
  • Were you given access to a restroom and water while detained?

  • Abuse by police and injuries (5 of 6)

  • Please select if the interviewee was subjected to any of the following use of force by the police:
  • Do you have any photographs or videos of your injury?
  • Did you get medical care to treat your injuries?
  • Do you have documentation of the medical care you received?

  • Final questions (6 of 6)

  • Thank you for filling out the intake.

    If necessary we will be in touch. We are proud to support you and the other protesters. This form creates no agreement or obligation for representation.  If you have any questions about the intake process please contact us directly at protestslosangeles@gmail.com.

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