Thank you for contacting Alameda County Behavioral Health regarding Alameda County DUI programs. This form is intended to collect information from  you regarding your DUI program request. Please complete this form to the best of your ability and a representative from the Alameda County Behavioral Health Substance Use Continuum of Care will be in contact with you within a 1 week period. If you have urgent questions or would like to request a follow-up, please email SUDSystemOfCare@acgov.org.
For general information about Alameda County DUI programs, please visit: http://www.acbhcs.org/dui-programs/



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* 1. What is the spelling of your first and last name?

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* 2. What is your phone number?

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* 3. Can a confidential voicemail be left at this number?

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* 4. What is your email address?

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* 5. What was the last DUI program you participated in?

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* 6. What is the purpose of your request today?

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* 7. Approximately what month & year were you dismissed from your DUI program? 

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* 8. What DUI program would you like to re-instate into?

For more information on Alameda County DUI programs, please visit: http://www.acbhcs.org/dui-programs/

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* 9. What year did you complete your DUI program?

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