MDOC Agent Referral Form CALL ETRS (800) 213-3877 to schedule your class or register online at www.etrsmichigan.com.Probation Agent(Required)Probation Agent Email(Required) Probation Agent Phone(Required)MDOC Client #(Required)MDOC Office(Required)Offense(Required)Participant Name(Required) First Last Date of Birth(Required)Participant Email(Required) Participant Phone(Required)Outpatient Programs AOD (Alcohol and Other Drugs) Outpatient Relapse Prevention Program (14 weeks $35/class): $490 AOD (Alcohol and Other Drugs) Outpatient Relapse Prevention Program (14 weeks $35/class) + Substance Abuse Evaluation: $490 Men’s Domestic Violence Orientation ($100) + 12-26 Weekly Sessions ($30/class) CBT/Positive Options Program: $240/8 sessions (Virtual Option) Economic Crime/Positive Options Program (Retail Fraud/Theft): $135/7.5hrs/4 sessions (Virtual Option) ETRS Educational Programs Alcohol Education Program - 2 Day: $225/13hrs (Virtual Option) Alcohol Education Program - 1 Day: $135/6.5hrs (Virtual Option) Anger Management Program - 2 Day: $225/13hrs (Virtual Option) Anger Management Program - 1 Day: $135/6.5hrs (Virtual Option) Drug Screens 4 Panel: $20 12 Panel: $45 Evaluations Substance Abuse Evaluation: $165 (Virtual Option) Driver’s License Appeal Evaluation: $375 (Virtual Option) Mental Health Evaluation: $225 (Virtual Option) Wayne County MDOC-Funded Programs - NO COST TO OFFENDER DDJR (Drunk Driver Jail Reduction / Adjudicated Release) Outpatient Relapse Prevention Program 14 weeks: GRANT FUNDED for MDOC 3rd offense OWI Felony Wayne Co. Residents Men’s Domestic Violence Orientation + 26 Weekly Sessions: GRANT FUNDED for Male MDOC Wayne Co. Residents with DV Charge 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 participant to take a virtual class?(Required) Yes No - it must be in person Completed by Date MM slash DD slash YYYY Δ
