DUI enrollment request | Bridges Professional Treatment Services

All new enrollments are by appointment only. Send this request and the DUI office will call you to set your appointment. Class space is limited, so do not wait until the last minute.

At your appointment, bring a photo ID, your court referral or DMV paperwork, and a $290 down payment ($630 full payment for Wet and Reckless) by money order or cashier’s check only.

Fields marked (required) must be filled in. Your information is sent securely and stored encrypted.

Program you were ordered to (required)

First name (required)

Last name (required)

Date of birth (required)

Phone (required)

Email (optional)

Class language (required) English Spanish

Driver's license number (required)

Referring court (required)

Or "DMV" if you were referred by the DMV.

Court docket number (required)

XRef number (required)

From your court paperwork. Write "none" if you do not have one.

Date you must enroll by (required)

Preferred intake date (required)

Street address (optional)

Address line 2 (optional)

City (optional)

State (optional)

ZIP code (optional)

Comments (optional)

I understand I must bring a photo ID, my court referral or DMV paperwork, and a money order or cashier's check for the down payment to my appointment. (required)