Certification and Program Forms
Starting a Program
There are approximately 55 Court Alcohol and Drug Programs within the state. A listing of these Programs is available from the Indiana Office of Court Services. These programs are governed by statute (IC 12-23-14) and by Court Alcohol and Drug Program Rules.
Court Alcohol and Drug Programs in Indiana are governed by statute (IC 12-23-14) and Judicial Conference Rules. Statutes and rules authorize the Indiana Office of Court Services to establish procedures to certify court alcohol and drug programs.
Client Demographics are due March 31, 2020 for the 2019 reporting period. Please complete all applicable forms pertaining to your program. There will be separate links for Felony charges (Part 2) and Misdemeanor charges (Part 3).
Documents and Forms
|Staff Update Form|
|Client Demographics - Part 1|
|Client Demographics - Part 2 (Felony)|
|Client Demographics - Part 3 (Misdemeanor)|
|Sample Criminal Justice Consent for Release of Information Form||Word|
|Sample General Consent for Release of Information Form||Word|
|Sample Response to Subpoena - Criminal||Word|
|Sample Response to Subpoena - Civil||Word|
|Sample Qualified Service Organization Agreement||Word|
|Sample Prohibition on Re-Disclosure||Word|
|Client Rights Form||Word|
|Client Signature Page||Word|
|Individual Service Contract Sample||Word|
|Sample Client Survey||Word|
|Sample Referral Agreement||Word|