In order to obtain an Alcohol and Drug Evaluation for the Circuit Court or the Office of the Secretary of State, I agree to provide the following information:
1) A copy of my driving abstract or written summary of my driving history obtained from the Office of the Secretary of State.
2) The written results of any chemical testing or documentation of refusal of such testing, that occurred after my arrest for driving under the influence of alcohol and/or other drugs (DUI)
3) Alcohol and drug use history, from first use to present
I also attest to the fact that I have not undergone any other alcohol and drug evaluation as a result of my DUI arrest or if I have, I agree to provide a copy of all such evaluations, if completed and/or the name and address of such program(s). I also give my consent for this program to obtain information from any program(s) where I previously began and/or completed any alcohol and drug evaluation relative to my arrest for DUI. I have read the Department of Human Services brochure entitle "A Guide to the DUI Evaluation Process" explaining the alcohol and drug evaluation procedure. I understand that I have the right to withdraw from this evaluation process at any time, refuse the completed alcohol and drug evaluation or seek a second opinion by obtaining another evaluation. I further understand that any information I do provide can be released to the Circuit Court, the Office of Secretary of State or the Department of Human Services upon request. If I do not complete the evaluation or do not return to sign and obtain my copy of the evaluation within 30 days of its completion date, notice will be send to the Circuit Court or the Office of the Secretary of State along with any relevant information pertaining to my involvement with this program.
Effective as of September 01 of 2004.
For your information .
Office of secretary of State has added a requirement that all
petitions alcohol/drug use history be included with the original
evaluation.
This to be provided by all Illinois licensed DUI service providers. (Ask for confirmation that this history has been completed and attach to your evaluation) without it you are receiving an incomplete Secretary of State document.