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Printable Registration Form

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What Should I Bring?

DAWN

 

(330) 834-1934 or toll free 1-800-374-6099

To check on availability and be tentatively scheduled for specific weekends or locations, call the number listed above. To finalize your registration, please print and complete the registration form and pre-intake form and include them with your payment. Payment can be made by cash, personal check, credit card or money order. Your registration is considered final only when payment is made. Payment must be made at least 7 days prior to the program date.

Mail your forms and payment to:
Quest Recovery and Prevention Services
100 Lincoln Way E. Suite 180
Massillon, Ohio 44646

Or you may register in person at Quest’s Massillon or Canton offices. Once registration is finalized, we will mail you a receipt, confirmation of the date and location of your program and additional information pertaining to your 72 hour stay. If you have any questions after reading this information, please do not hesitate to contact us.


 

"Quest’s 72-hour Driver Intervention Program complies with court sentencing and helps you develop an individualized plan to avoid additional DUI/OVI arrests in a comfortable, non-judgmental environment. "
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