Initial Enrollment Request Form

You have three options for scheduling an enrollment:

Call OHS Enrollment Specialists at 1(855) DUI-8055 to schedule an enrollment into our program.
Call the OHS office directly Monday - Friday between the hours of 9:00 AM - 6:00 PM or on Saturday from 9:00 AM to 3:00 PM (Oakland, San Jose and San Marcos offices ONLY).
Fill out the form below and submit via e-mail to OHS and someone will contact you to schedule an appointment.

San Diego County

Select the program you are required to attend.

DUI Program

6-Week Wet/Reckless Program 3-Month First Offender Program 6-Month Enhanced First Offender Program 9-Month Enhanced First Offender Program 18-Month Multiple Offender Program

Anger Management Program

Alcohol & Drug Assessments (ASI)

Contact Information

First Name *

Last Name *

Date of Birth

Driver's License Number

Referring Court

Court Docket Number

Street Address *

City *

State *

Zip Code *

Email *

Phone *

Date you must enroll by *

Comments

*This form will send your message to OHS as an email. The email is not encrypted and is not transmitted in a secured format. By communicating with OHS through email, you accept associated risks. OHS does not accept responsibility or liability for any loss or damage arising from the use of email. To ensure the safety of your PHI and PII, you may call 1(855) DUI-8055.