DUI School, DDC Classes & Victim Impact Panel Pre-Registration Form
Road to Recovery, Inc.  All rights reserved; 1995-2015
Schedules are subject to change without notice
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Your full name:
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Email:
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Phone number:
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DUI Class (Risk Reduction Program)
Select class
DDC Class
Victim Impact Panel
Please select
the location
of your
preference:
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Atlanta Clinic
Forest Park Clinic
Gainesville Clinic
Marietta Clinic
Use this box to ask us specific questions or make a comment:
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IMPORTANT INFORMATION: This is a pre-registration form. To complete your registration process for DUI School, you
will need to complete a NEEDS Assessment. The NEEDS assessment is a 130-question, comprehensive, adult
assessment tool. This instrument addresses life stress, attitude and emotional stability, criminal history and alcohol
/drug use based on DSM-IV and ASAM guidelines.
You will need to schedule an appointment at least 24 hours prior
to the start of your class.
The NEEDS Assessment takes 45-60 minutes to complete.

There is no assessment component for DDC or Victim Impact Panel; however, you must complete all requirements at
least 1 hour prior to the start of your scheduled class. If you need additional information
please contact us.
"A journey of a thousand miles starts with the first step"