Evaluation Registration

Drug and Alcohol Evaluation Registration Form

Use the form below to register for an appointment with a State Licensed Evaluator.

Remote, Online Tele-health Evaluations

Evaluations are available to be completed remotely via a telehealth session. This appointment can be completed with most devices that have a camera and microphone, including a laptop computer, Android phone, Apple iPhone and most tablets.

Appointment Information

Enter the information below as it would appear on your Driver's License or State Issued Photo ID. If you have a DDS Identification Card, the ID Number is the same as your License Number.

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Verify that your phone number and e-mail are correct!(Required)

I understand I will receive a phone call or e-mail to set my appointment time & have verified my phone number is correct.

License/Photo ID Upload

Attach a copy of your photo ID below or e-mail it directly to [email protected]. You can scan in your ID or take a clear photo with your smartphone camera.

Max. file size: 50 MB.

Evaluations (Anger, Drug and Alcohol, Out of State)(Required)

Online registrations are not refundable. Once you have finished registration, our staff will contact you during the next business day to finalize your appointment time.

Drug and Alcohol Evaluation for Probation or Court: $150.00

Evaluation After Substance Abuse Treatment: $165.00

Anger Evaluation: $175.00

Out of State Evaluation: $200.00

Important: Have you had two (2) or more DUIs in the last 10 years?(Required)

Yes

Two (2) or more DUIs in the last 10 years? Please call our office and speak to a staff member at 770.769.7279 before you submit this registration!

If you've had two (2) or more DUIs in the last 10 years, you will want to speak to a staff member first to find out more about the GA multiple offender program and how it works. If you submit this form anyway, it may incur a fee. Our staff can get you signed up for the correct program for your situation.

Urgent Processing Option and Payment

Emergency/Urgent Evaluation

If this is an emergency/urgent situation and you need your evaluation returned to your lawyer, probation office, or other organizaiton faster than typical 48-72 hours after your appointment, please select the option below.

Urgent (ASAP) Processing

Total

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

CAPTCHA

Drug and Alcohol Evaluation Registration Form

Remote, Online Tele-health Evaluations

Appointment Information

Two (2) or more DUIs in the last 10 years? Please call our office and speak to a staff member at 770.769.7279 *before* you submit this registration!

Urgent Processing Option and Payment

Registration Forms

Two (2) or more DUIs in the last 10 years? Please call our office and speak to a staff member at 770.769.7279 before you submit this registration!