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Reentry
Reentry Self-Referral Form
Reentry Referral Form
[Our intake is closed between 12/14-1/4. Any forms submitted during this time will be responded to after 1/4]. Use this form to reach BayLegal's Reentry unit if you have ever been arrested or convicted of a crime and have a legal issue you would like help with. All the information you provide on this form will be used only to help us reach you and connect you with legal and other resources. Beyond those uses it will be kept confidential and anonymous unless you authorize us to share it with other parties.
Contact Information
Name
*
First
Middle
Last
County Where You Live
*
Alameda
Contra Costa
Other (advice/referral only)
BayLegal can provide reentry legal services to residents of Alameda and Contra Costa Counties. We are happy to provide advice and referrals to residents of other counties.
Is is safe to send you mail?
*
Yes
No
Mailing Address
Street Address
Address Line 2
City
ZIP / Postal Code
Is there a safe phone number for us to reach you?
*
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No
Phone Number
Is it alright to text you?
*
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No
Email Address
Information About You
Date of Birth
*
Date Format: MM slash DD slash YYYY
Languages You Speak
Are you a U.S. citizen?
*
Yes
No
Information About Your Legal Issue
How did you hear about Bay Area Legal Aid / Who referred you?
The legal issues for which I am seeking help include:
Suspended driver's license
Unpaid traffic tickets, court fines, or fees
Employment denials because of background checks
Professional/vocational license denial
Federal student loan discharge/deferment
Help with consumer debt
Help with credit reporting
Help with identity theft issues
Criminal record expungement
Early termination of probation
Correcting an error on your record/RAP sheet
Outstanding warrants (advice only)
(Check all that apply)
Please describe your legal problem
*
