Emergency contact

    Referring Agency



    Problem statement:
    Client assigned education/treatment due to DUI arrest.

    Goals: Client will be able to demonstrate that they have gained knowledge regarding the effects of alcohol/drugs on the body, mind and emotions. They will also demonstrate knowledge of the legal and economic realities of receiving a DUI. They will also become knowledgeable regarding treatment alternatives.

    Tasks: The client will participate in class and complete assignments as assigned.

    Frequency of treatment: The client will attend at least one times weekly for two
    hours, until completion of treatment.

    Discharge goals/plan: Client will demonstrate knowledge by successfully completing the DUI Post Test with at least 70% accuracy.

    I have participated in the creation of my treatment plan and agree to participate fully.

    Please use your mouse our touch screen to sign below.