Substance Abuse Evaluation

Please complete this full evaluation.

Clinical Evaluation Contract: This gives us permission to do your evaluation. 

DUI Intervention Program – ALL Clients: This gives you information about what happens when you get a DUI in the state of Georgia. You must sign that you read and understood this document.

All First Offender DUI Clients – *ONLY COMPLETE THIS FORM IF YOU HAVE ONLY ONE DUI IN YOUR LIFETIME (INCLUDING THIS ONE)* – This form gives you information about what happens the first time you get a DUI in the state of Georgia. You must sign this document that you read and understood this document – only if this is your first DUI ever. If this is not your first DUI, please complete the next form for multiple DUI offenders.

All Multiple Offender DUI Clients – *ONLY COMPLETE THIS FORM IF YOU HAVE TWO OR MORE DUI’S* – This form gives you information about what happens if you have multiple DUI’s in the state of Georgia. If you have two or more DUIs in your lifetime, you must sign this form stating you have read and understood its contents. If this is your first DUI ever, please do not complete this form, please complete the form above instead.

HIPPA Notice of Privacy Practices: This form explains your rights & responsibilities as a client, as well as explains the limits of confidentiality. You must complete this form stating you have read and understood its contents.