Need Help with Bail? – Excelsior Wellness

Name of Jail Facility (Required)

Information on the Person Who Needs Bail Support Services

First Name (Required)

Middle Name

Last Name (Required)

Birthdate (Required)

Address (Required)

Street Address

Apt, Suite, or other Number needed

City

State

Zip Code

Phone Number (Required)

Race/Ethnicity

Gender

Preferred Language

Case Information for the Person Who Needs TBP Support Services

While we prioritize assistance on bail amounts of up to $5,000 to maximize the number of people we can help, we review all referrals and take individual circumstances into account.

Total Bond Amount Requested (Required)

Bond Requirements (Required)

Date Booked Into Jail (Required)

Booking Number

Case Number

Next Court Date (Required)

Next Court Time (Required)

If Applicable, enter Attorney Information below.

Attorney First Name

Attorney Last Name

Attorney Email

Attorney Phone Number

Your Information / Person Requesting Support from TBP

Your First Name (Required)

Your Last Name (Required)

Relationship to Person in Jail (Required)

Your Phone Number (Required)

Your Email (Required)

Subject

Your Message