Forms - Intoxicated Driver Program

The following are forms produced by the Department of Health Services (DHS).  For information on forms produced by the Department of Transportation (DOT), please see page 4 of the Intoxicated Driver Program Directory (PDF, 202 KB).

FORM NUMBER FORM TITLE LANGUAGE
F-20933 Court Order for Assessment English
F-20933S Orden de la Corte Para Evaluacion Spanish
F-20934 Court Ordered Assessment and Plan Report English
F-20934S Evaluacion Ordenada Por la Corte Y Reporte Del Plan Spanish
F-20934A Plan Recommendation English
F-20934AS Plan de Recommendacion Spanish
F-20935 Status Report to Court for Plan Compliance English

These forms are for use by state, county, and local officials involved with the Intoxicated Driver Program.

Return to the main page for the Intoxicated Driver Program

 

Last Revised: June 23, 2015