Expungement Clinic Sign-Up

Expungement Clinic Sign-Up

Register for an intake appointment. Your information will help us determine your eligibility for expungement assistance.
Contact Information
Full Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Eligibility Screening
Are any of your charges for Crimes of Violence, Sex Offenses, Offenses against Minors, Domestic Abuse/Stalking?
Are you currently represented by an attorney?
Are your charges in/for Tangipahoa Parish?
Have you previously applied for expungement?
Case Details
List all conviction(s) or charge(s).
Consent
I understand that submitting this form does not guarantee legal representation.
I consent to be contacted by the clinic for follow-up.
Should be Empty: