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Printable Pre-Intake Form

DAWN

 

Required Items
1.Form of identification (picture ID, social security card, birth certificate)
2.Change of clothing for three days. Comfortable clothing is recommended.
3.Appropriate nightwear (You will be sharing your room with another participant.)
4.Personal necessities/toiletries (soap, shampoo, razor)
5.Robe/slippers
6.Bath towels (Massillon and D.A.W.N. locations only)
7.Prescription medication (Please bring only the quantity required for your stay in the program in the properly labeled RX container.)

Optional Items
1.Money for vending machines/payphones. Phone cards for long distance calls (if available)
2.Reading materials
3.Pop and snacks in original, unopened packaging.
4.Over the counter medications, such as Tylenol, vitamins or cold medication. (Must be in original, unopened containers.)
5.Cell phone

Note: Laptop computers are not permitted. Homemade food is not permitted.

 

"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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