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3945 SE Hawthorne Blvd. Portland, OR. 97214
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About
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COST OF DUII DIVERSION
SIGN UP for DUII/Diversion INTAKE SESSION
Client Resources
New Agency Referral Form
Established Referral Form
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Nonprofit Organization Status
T
eras Intervention and Counseling Inc.
is designated by the IRS as a 501 C(3) not- for-profit charitable organization. All gifts and monetary donations are tax deductible.
EIN 26-4575033
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CLIENT RESOURCES
A&D Treatment Tools
Domestic Violence Program Tools
Anger Management Tools
Client Bill Payment
Client Action Plan
HELPFUL CLIENT FORMS
Sign up for DUII Diversion Intake Session
Notify Program of a Missed Appointment
Request
Approval for Leave of Absence
Change of Contact Information Form
Self Referral form
(other county,state or voluntary)
REDUCED FEE INDIGENT STATUS FORMS
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Indigent Status Packet
(fill out to qualify for reduced fees)
Budget Worksheet
(fill out for reduced fee clients only)
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