Assessment/Treatment Report for DASA Certified Agencies
We must receive this assessment/treatment report following a driver license suspension or revocation for a driving under the influence (DUI) or physical control conviction. Based on the assessment, the driver will be required to attend alcohol information training or provide proof of at least 60 days of treatment before regaining his or her driving privileges.
Instructions
- The report must be completed and sent to us by an alcohol or drug treatment facility approved by the Department of Social and Health Services, Division of Alcohol and Substance Abuse (DASA).
- All forms must be printed on white paper.
Assessment/Treatment Report for DASA Certified Agencies form.