MADD Lawyers
Resource Network

Information Request

Need more information?

To learn more about the MADD Lawyers Resource Network please submit the form below and someone from MADD will be in contact soon.

First Name(Required)

Last Name(Required)

Email(Required)

Phone(Required)

Firm Name(Required)

Address(Required)

City(Required)

US States(Required)

Zip(Required)

Coverage Areas(Required)

First Name(Required)

Last Name(Required)

Email(Required)

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Gain New Connections and Support for Victims and Survivors

Every year, thousands of individuals impacted by impaired driving turn to MADD for help. Many of them face confusing legal questions and overwhelming challenges. Through this initiative, we aim to:

Empower survivors and victims by offering trusted legal support
Elevate the legal profession by aligning with attorneys who share our values
Provide access to ethical, compliant service partners across all jurisdictions
Fuel our mission through sustainable revenue that supports our mission

How It Works

This is a strategic partnership rooted in ethics, transparency, and meaningful support. MADD will carefully vet attorneys through an application process. Participating lawyers will be featured in our network for the general public.

MADD Lawyer Network Application

Applicants are responsible for complying with the MADD Lawyer Network rules outlined in this application to the satisfaction of MADD.

Failure to comply with the MADD Lawyer Network rules outlined in this application may result in suspension from the service. Attorneys will be notified in writing and be given 30 days to respond to the alleged rules infraction. If no response is received, a second written notice will be given with the attorney having 10 days to respond. If there is no response, the attorney will be suspended from receiving referrals until the attorney is in compliance with the MADD Lawyer Network rules.

INSTRUCTIONS: The following are instructions to assist with the completion of this application.

● Complete all fields, answer all questions completely, and initial where required.

● An application fee of $300 will be required today.

● Please allow approximately 30-60 days to process and review this application.

● Your application will be evaluated for accuracy and compliance with MADD’s charitable mission.

● Incomplete applications will be rejected.

● Applicants must include a copy of their Certificate of Professional Liability Insurance to this application.

● The status of your application will be communicated in written form.

Section 1: Personal Information

Contact Information

First Name

M.I.

Last Name

Any other names or aliases used

Street Address

City

State (Note: Only one state per application):

Zip

Telephone Number

Email Address

ANNUAL FEE

Your state is not currently eligible. Click SUBMIT to be contacted when your state is added and eligible.

ANNUAL FEE

Annual fees will be collected through a separate process after approval has been granted. An annual fee of $25,000 is required for participation in the MADD Lawyer Resource Network, in accordance with the ethical guidelines of your jurisdiction.

ANNUAL FEE

Annual fees will be collected through a separate process after approval has been granted. You have two tiers of Annual Fees to choose from:
Tier 1: $25,000 a year, or
Tier 2: $10,000 a year + 7% referral fee where allowed (7% of attorney's fees received in any case originating from the MADD Lawyer Resource Network
These fees are required for participation in the MADD Lawyer Resource Network, in accordance with the ethical guidelines of your jurisdiction.

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Additional Contact Information

Use this information to share additional contacts for your practice

First Name

M.I.

Last Name

Telephone Number

Email Address

First Name

M.I.

Last Name

Telephone Number

Email Address

Firm Information and Web Presence

Firm Website

Personal Website(s)

Martindale-Hubbell AV Rating

Instagram

Facebook

TikTok

Twitter

Other

Bar Information

In which state(s) are you licensed?

AL	AZ	DC	GA	HI
IL	KY	LA	MD	MS
MT	NC	ND	NV	NY
OR	PA	RI	SC

List your Bar number(s)

When were you first licensed as an attorney?

Please list any disciplinary proceedings that have been initiated against you.

Dram Shop Liability

Does your state have Dram Shop Liability?

YesNo

If so, have you represented a plaintiff in these cases?

Describe your experience representing Dram Shop cases (for example: how many, what percentage were successful, etc.).

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Section 2: Requirements

State Certification

I confirm that my state authorizes my participation in the MADD Lawyer Network. This information can be obtained by finding the section of your state’s Bar association rules regarding communications concerning a lawyer’s services. Also see ABA Model Rule 7.2(b)(2). If you practice in multiple states, you will not receive connections in the states in which referral fees are prohibited.

Initial Here

Malpractice Insurance

I confirm that I have a minimum of [$1,000,000.00] in malpractice insurance coverage and have attached a copy of my Certificate of Professional Liability Insurance. I understand that this certificate must be provided annually at least 30 days prior to the expiration date of the current policy. Failure to do so could result in suspension from the service.

My current malpractice policy expires on:

Please attach a copy of your Certificate of Professional Liability Insurance:

Initial Here

Ongoing Learning

I confirm that I will complete the included MADD Online Course: Best Practices Around Service Provision to Victims/Survivors of Impaired Driving prior to being added to the MADD Lawyer Network.

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Non-Assignment

I confirm that I am the primary attorney who will performing the majority of the work required to serve any clients that I retain from the MADD Lawyer Network. I will not redirect or reassign any work from a case I retained through the MADD Lawyer Network to anyone outside of my firm regardless of circumstance or professional experience.

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Representation

I confirm that I have not represented an impaired driver in the last 10 years, do not currently represent any impaired drivers, and will not represent any impaired drivers while I am a part of the MADD Lawyer Network.

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Client Review

I understand that MADD may interview former or current clients of mine as part of the initial eligibility review or as part of my renewal of eligibility. I will make best efforts to obtain the client’s review of MADD Lawyer Network and share the same with MADD Lawyer Network.

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Background Check

I understand that MADD will perform a background check at least every [5] year(s), the results of which will be reviewed by MADD to determine my initial or continuing eligibility for the MADD LRS.

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Conflict of Interest

I understand that my service on the MADD National Board of Directors or a local office Advisory Board (each, a “Board”) is an inherent conflict of interest. I have received written approval to be a part of the MADD Lawyer Network from the relevant Board, by a majority vote, and have shared this information with MADD.

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Mission Alignment

I understand that MADD may terminate my eligibility for the MADD Lawyer Network if my actions are deemed, at the sole discretion of MADD, to be misaligned with MADD’s charitable mission. An example includes, but is not limited to, any evidence of impaired driving.

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Term/Renewal

I understand that MADD will require me to complete an annual application for the purpose of reviewing my continued eligibility for the MADD Lawyer Network.

Initial Here

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Section 3: Agreements

License Agreement

I have read the license agreement regarding MADD logos and taglines and agree to its guidelines.

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Photo Release

I grant permission to MADD to use any photos I provide them for the purposes of, but not limited to, publicity, copyright, illustration, advertising, and web content. I understand that no royalty or compensation will be provided to me as a result of such use.

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Self-Reporting Requirement

I agree that, should any of the submitted information change or any new information become available that would lead one to reasonably believe my eligibility for the MADD Lawyer Network would be impacted, it is my responsibility to inform MADD immediately by contacting the legal department at [email protected].

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Service Charges

I agree that any charge for service(s) will be agreed upon with the client in keeping with the objectives of the MADD Lawyer Network which means they will not exceed 40%.

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Consultations

I agree to provide all clients referred by the MADD Lawyer Network a consultation as soon as possible after the request is made unless such consultation conflicts with my professional responsibilities.

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Rejected Referrals

I agree to notify the MADD Lawyer Network of any rejected connections within 5 business days to ensure that any potential clients are supported by MADD Lawyer Network as efficiently as possible.

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Status Reports

I agree to submit a status report to the MADD Lawyer Network within 30 days of receipt of the connection, and on a quarterly basis thereafter.

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Application Fee

Charge for Today:

Total Due Today:

Name on Card

Card Number

Code

Billing Email

I hereby certify that the information provided on this form is, to the best of my knowledge, true and accurate. I understand that failure to provide true and accurate information could result in my suspension from the MADD Lawyer Network.

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