If you had your non-DUI evaluation completed by someone other than Choice Counseling Center, please fill out the following forms:

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 that you have read and understood this document.

Consent for the Release of Information: Please complete this form and provide us with your probation officer’s information. If you are not on probation, please provide us with the contact information of whomever referred you: i.e. attorney, pre-trial officer, employer, employee assistance program, military, etc. If you do not provide us with a signed consent form, we cannot send your referral source an evaluation or even communicate with them that you came to us. If you would like your evaluation sent to multiple sources, please complete this form multiple times, once for each source. 

Below are the group rules for attending group counseling sessions with Choice Counseling Center. Please sign that you have read and understood these rules.

Thank you for completing all the forms. You are now registered for groups. Now you can download the ZOOM app from the app store on your phone or you can familiarize yourself with the zoom.us website. All of our groups are held virtually on zoom for the time being during the COVID pandemic. We will contact you with the login and passcode for your group and the schedule.