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COASTAL BEND REGIONAL

COURT RESIDENTIAL TREATMENT CENTER

800 N. VINEYARD
SINTON, TEXAS 78387
(361) 364-4323 /

Counties

Aransas
Bee
Live Oak
McMullen
San Patricio
36th, 156th, 343rd
District Courts

To: Community Supervision and Corrections Departments

Thank you for your interest in the Coastal Bend Regional Court Residential Treatment Facility. Enclosed is a Referral Packet Checklist for placement in our program.

Please submit the documents on the Referral Packet Checklist to review eligibility to our program. All information must be received to complete the screening process and placement. If your counties’ Community Supervision and Corrections Department does not provide our assessments listed in Referral Packet Checklist, we will consider similar screening tools comparable to our assessments.

If you have any questions or need further assistance in completing the Referral Packet Checklist, please contact me.

Sincerely,

Linda Diaz, Ph.D., LPC-S

Director of Residential Services

Coastal Bend Regional

Court Residential Treatment Center

800 N. Vineyard Avenue

Sinton, Texas 78387

Office: (361) 364-4323, Ext. 11

Fax: (361) 364-2768

Email:

Form.012

09/11

36th, 156th, and 343rd JUDICIAL DISTRICTS

COMMUNITY SUPERVISION AND CORRECTIONS DEPARTMENT

Coastal Bend Regional Court Residential Treatment Center

Sinton, Texas

After the case has been staffed and determined appropriate for the CRTC, a packet will be prepared to include the following information (submit two copies). Separate packets to be submitted for the treatment and employment phase of the program. If not applicable indicate N/A.

CRTC / Defendant’s Name:
Intra-State Transmittal Form (out of county only)
Supervision Plan
Current Photograph
Uniform Referral Form
Personal Data Sheet
Judgment; Conditions; Orders Amending; MTRs; Orders Continuing
CJAD Risk Needs Forms
Texas Uniform Health Status Form
Offense Report
Criminal History
Alcohol/Drug History (Dopers), SAE, SAI
Mortimer-Filkens (Questionnaire & Interview) – Alcohol Driving Offenses Only
WRAT
SASSI (for other than alcohol driving offenses)
MMPI
Psychological, SCS, PSI (if available)
Urinalysis results
TB Test results (skin tests may be submitted positive but admission screening will not be conducted until x-ray and a clean medical report are received)
MUST ATTACH COPIES OF THE FOLLOWING:
Drivers License or Texas ID or Birth Certificate
Department Financial Status Report
Social Security Card
Assigned Supervision Officer:
Supervisor at Staffing:
Date of Staffing: