If you are new, please feel free to fill out these intake forms before our first session. These forms can also be filled out during the first session.
All comprehensive Assessments will be conducted in-person and on a walk-in basis. Walk-in days are Tuesday and Wednesday in Round Lake, and Thursday and Friday in Waukegan. Arrive early to sign in (sites open at 8am) as only 3 comprehensive Assessment appointments will be conducted each day. If you are unable to attend during walk-in hours, please call (847)546-6450 to schedule an appointment.
All DUI Assessments will be conducted in-person and on a walk-in basis. DUI walk-in days are Thursday and Friday in Round Lake, and Tuesday and Wednesday in Waukegan. Arrive early to sign in (site opens at 8am). Individuals will be seen as soon as possible, but may not be seen until the afternoon depending on how early they sign in. If you are unable to attend during walk-in hours, please call (847)546-6450 to schedule an appointment.
English
Evaluation - Gambling (English)
Evaluation - Non-DUI (English)
Intake - GOALS and Anger Management (English)
Intake - Minimal Risk (English)
Intake - Moderate Risk (English)
Intake - Retail Theft (English)
Intake - Treatment (Significant, High Risk, and Intensive Outpatient)
Telehealth Services Agreement (English)
Universal Precautions and Information-Influenza, HIV, and TB (English)
Spanish - Español
Evaluation - DUI (Spanish) - Evaluación para la Conducción Bajo la Influencia de Alcohol y/o Drogas
Intake - High Risk (Spanish) - Admisión de Alto Riesgo
Intake - Minimal Risk (Spanish) - Admisión de Bajo Riesgo
Intake - Moderate Risk (Spanish) - Admisión de Riesgo Moderado
Intake - Significant Risk (Spanish) - Admisión de Riesgo Significativo
Telehealth Services Agreement (Spanish) - Acuerdo de Consejería por Teléfono y/o Video
Please complete these steps and bring documentation to your first DUI appointment.
Instrucciones para la Documentación Necesaria para una Evaluación para la Conducción Bajo la Influencia de Alcohol y/o Drogas (Español).
DUI Evaluation
Required Documentation Instructions
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