**CLIENT CONTRACT**

22^nd^ JUDICIAL DISTRICT

DRUG COURT TREATMENT SERVICES

I HAVE CHOSEN TO COMPLETE TREATMENT IN THIS PROGRAM. TO ASSURE MY FULL
PARTICIPATION IN THIS DRUG AND ALCOHOL FREE PROGRAM, I AGREE TO THE
FOLLOWING REGULATIONS:

1.  I understand that I must attend all scheduled sessions and
    appointments made by the staff. If it is necessary to miss any
    sessions, I will notify the clinic and bring documentation, typed on
    their letterhead, from my employer or doctor for verification. If I
    fail to call and bring verification to me next schedule session, it
    will be considered an unexcused absence. Each absence, whether
    excused or not, will be included in the status report sent to the
    judge.

2.  I understand that I will be required to submit to breath test to
    verify I am alcohol free. If I am found to be drinking at anytime
    during my treatment, I agree to follow through with referral to
    detox, inpatient or any recommendation by the treatment staff. If
    sent to detox or inpatient, I agree to return to the clinic
    immediately upon release from such a facility to check-in with staff
    to reassess my lever of participation in the program.

3.  I understand that I will be required to submit to random supervised
    urine screens. If I fail to produce a urine specimen or if it is not
    of sufficient quantity, it will be considered a stall on my part and
    it will be treated as if it was positive for drugs/alcohol. If I am
    found to be using at anytime during treatment, I agree to follow
    through with referral to detox or impatient, I agree to return to
    the clinic to check-in with staff to reassess my level of
    participation in the program.

4.  I understand I am responsible for informing and providing
    documentation of all prescription medications I am taking. I am also
    responsible for notifying staff if there are any changes to the
    prescriptions.

5.  I understand that I am required to participate in all scheduled
    sessions. Failure to participate will noted by my counselor who will
    include this in the status report to the judge.

6.  I understand that part of my program includes attendance of at least
    three open AA/NA meetings each week. I agree to bring verification
    of attendance to my counselor as scheduled.

7.  I understand that while I am waiting for admission into a detox or
    inpatient facility, should it be recommended, I will continue to
    maintain scheduled clinic appointments.

8.  I understand that I am required to inform staff of any
    over-the-counter medications I may be using and that they are to be
    non-addictive and not contain alcohol. I am also responsible for
    confirming with a pharmacy or medical professional that these
    medications are non-addictive and do not contain alcohol. I
    understand that using mood-altering medications prescribed or not
    could exclude me from participation in the program.

9.  I understand I am to cooperate with the treatment staff in
    formulating my treatment plan. I agree to sign the consent forms for
    the release of information in order to help the staff communicate
    with individuals or agencies that can assist me in my recovery.

10. I understand that sanctions may be imposed by the judge for my
    failure to comply with the treatment program. I understand that my
    failure to comply with the programs can result in additional
    conditions and requirements that will be made part of my treatment
    plan. I agree to comply with the additional requirements in order to
    continue in the program.

11. I understand that if I am found to be under the influence of drugs
    or alcohol when I arrive for a treatment session, I will not be
    allowed to stay and participate. I agree to surrender my keys to the
    staff for my safety as well as others. I will call someone who is
    not under the influence to drive me home.

12. I understand that if I insist on driving, the staff will be
    obligated to notify the sheriff's department of an impaired driver
    on the road and a description of the vehicle will be given.

I HAVE READ AND UNDERSTAND THE CONTRACT. I AGREE TO FOLLOW THESE
REGULATIONS.

Client:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date:\_\_\_\_\_\_\_\_\_\_\_\_\_

Staff:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date:\_\_\_\_\_\_\_\_\_\_\_\_\_