Proudly Serving Calumet City, Chicago South Suburbs & Northwest Indiana
(708) 862-4054
1609 Sibley Boulevard
Calumet City, IL 60409
First Name:
Last Name:
Email:
Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Work Phone:
Emergency Phone
Social Security Number:
Date Of Birth:
Driver's License #
Reason For The Call:
Other:
Probation Officer's Name
FED
COUNTY
COUNTY/FED
Office Phone:
Office Fax:
County Court Supervision/Social Worker
COUNTY/FED
Office Phone:
Office Fax:
Please Choose Which Applies:
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READ THE DETAILS BELOW CAREFULLY BEFORE SUBMITTING THIS FORM:
Please complete the form provided below
Identify your service needed below to know The things that you will need to bring with you to begin:
DUI Unified Evaluation Report
YOU WILL NEED TO BRING:
1.  A photo ID
2.  A Driving Abstract (record of your driving  from Secretary of State about $13)
3.  Court Papers
4.  Name, phone number and fax number of your Supervision/Social Worker
5.  Ticket (if possible)
6.  Police report that indicates if you took a breath-a-lizer, road sobriety test and results
7.  NO CASH.  Money Order, Credit Card or Check for $300.00
Alcohol & Drug Evaluation
YOU WILL NEED TO BRING:
1.  A photo ID
2.  Documents indicating WHO is requesting an Alcohol & Substance Abuse Evaluation and WHO needs the report and contact information
3.  Documents indicating WHY you need an Alcohol & Substance Abuse Evaluation
4.  All related Court Documents
5.  NO CASH.  Money Order, Credit Card or Check for $300.00
Evaluation Update
YOU WILL NEED TO BRING:
1.  Initial Uniform Evaluation Report 
2.  If we did not do the initial report, we'll have to do a regular evaluation.  Not a problem, just  a State regulation.  (See Uniform Report) 
3.  Significant other, parent, sister, brother, or friend who can confirm your report.
4.  NO CASH. Money Order, Credit Card, Check for $300.00
Has Evaluation/Needs DUI Classes
YOU WILL NEED TO BRING:
1.  Unified Evaluation Report
2.  Photo ID 
3.  NO CASH.  Money Order, Credit Card, Check for $300.00 
Has Classes/Needs Aftercare
YOU WILL NEED TO BRING:
1.  Photo ID
2.  Unified Evaluation Report 
3.  Certified Completion of Recommended Classes
4.  NO CASH.  Money Order, Credit Card, Check for $30https://www.amazon.com/gp/video/signup/ref=atv_pft_ps0.00