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Call Us: (800)-213-ETRS
Wayne County: 734-462-3096
Oakland County: 248-399-2600

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(800)-213-ETRS | Wayne County: 734-462-3096 | Oakland County: 248-399-2600

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MDOC Agent Referral Form

CALL ETRS (800) 213-3877 to schedule your class or register online at www.etrsmichigan.com.

Probation Officer/Agent(Required)

Probationer/Participant/Client Email(Required)

MDOC Client #(Required)

MDOC Office(Required)

Offense(Required)

Client/Probationer/ Participant Name(Required)

First Last

Date of Birth(Required)

Phone(Required)

Outpatient Programs (Virtual Options provided). CALL ETRS (800) 213-3877 to schedule your class or register online at www.etrsmichigan.com.

Outpatient Relapse Prevention Program - $100 Assessment and $30/week for weekly groups

Substance Abuse Assessment (Includes 4-panel drug screen) - $100

Drivers Licenses Appeal (includes 12-panel drug screen) - $350

Mental Health Evaluation - $200

CALL ETRS (800) 213-3877 to schedule your class or register online at www.etrsmichigan.com.

Wayne County MDOC-Funded Programs - no cost to offender (Virtual Options provided). CALL ETRS (800) 213-3877 to schedule your class or register online at www.etrsmichigan.com.

Men’s Domestic Abuse – 1 Day Orientation and 26 weekly 90-min follow-up sessions - NO COST TO WAYNE CO. FELONY DV OFFENDERS

Wayne County Felony OWI Offenders - Outpatient substance Abuse Program - 14 weeks - NO COST TO WAYNE CO. FELONY OWI OFFENDERS

CALL ETRS (800) 213-3877 to schedule your class or register online at www.etrsmichigan.com.

ETRS Programs (Virtual Options provided). CALL ETRS (800) 213-3877 to schedule your class or register online at www.etrsmichigan.com.

M20 Alcohol Weekend Education - $200 / 13.0 hrs

M21 Alcohol One Day Education - $120 / 6.5 hrs

M25 Anger/Aggression Management Weekend - $200 / 13.0 hrs

M26 Anger/Aggression Management One Day - $120 / 6.5 hrs

M27 Retail Fraud/Economic Crime Four Weeks (1½ hrs/week) - $120 / 7.5 hrs

M28 CBT: Concentrate on Better Thinking/Positive Options - $200 (8 sessions, utilizes interactive journaling)

CALL ETRS (800) 213-3877 to schedule your class or register online at www.etrsmichigan.com.

If you are recommending a Wayne County MDOC-Funded Program, please upload the BIR below.

Max. file size: 50 MB.

If you are recommending a Wayne County MDOC-Funded Program, please upload a Compass Bar Chart below.

Max. file size: 50 MB.

Will you allow your probationer to take a virtual class? CALL ETRS (800) 213-3877 to schedule your class or register online at www.etrsmichigan.com.(Required)

Yes

No - it must be in person

CALL ETRS (800) 213-3877 to schedule your class or register online at www.etrsmichigan.com.

ETRS Michigan can reach out to clients via SMS to communicate about registering for a class and answering questions. • Messaging frequency may vary. • Message and data rates may apply. • You can opt out any time by texting STOP. • For assistance, text HELP or visit our website at www.etrsmichigan.com. • Visit https://etrsmichigan.com/privacy-policy/ for privacy policy and https://etrsmichigan.com/privacy-policy/ for Terms of Service.

OPT IN

OPT OUT

• Messaging frequency may vary. • Message and data rates may apply. • You can opt out any time by texting STOP. • For assistance, text HELP or visit our website at www.etrsmichigan.com. • Visit https://etrsmichigan.com/privacy-policy/ for privacy policy and https://etrsmichigan.com/privacy-policy/ for Terms of Service.

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Virtual Classes Available!

Economic crime, positive options, group alcohol, anger management, cognitive Behavioral therapy (CBT)

With approval from probation.