Boca Bay DUI Program, Inc.
DUI SCHOOL · DRUG ALCOHOL TRAFFIC EDUCATION · DRIVER IMPROVEMENT
1. ENROLLMENT
DUI clients must enroll in person at the Boca Bay DUI Program, Inc., 100 S Military Trail #19, Deerfield Beach, Florida. DUI enrollment hours are Monday through Friday 9am to 5:30pm and Saturday 10am to 2pm.
Boca Bay DUI Program, Inc. may refuse to enroll anyone who is unwilling to comply with the rules and procedures of the program, or who is unwilling to make full disclosure for the purpose of evaluation.
Boca Bay DUI Program, Inc. and its clinical staff are certified by the Department of Highway Safety and Motor Vehicles DUI Programs Section.
2. CLASS PLACEMENT
All first offenders enrolling according to Section 316.192 or 316.193, F.S., shall be placed in the DUI Level I course.
Clients who have previously been convicted for driving under the influence, or have previously been ordered to, or have attended a DUI course, shall attend the DUI Level II course.
Boca Bay DUI Program, Inc. personnel will check each client"s arrest and driving records. Any client who (a) fails to report a prior DUI/DWI offense (including any DUI/DWI charge later reduced to Reckless or Careless Driving), or any DUI/DWI charge by the U.S. military or other government agency or any state other than FL, or (b) fails to report previously attending any DUI/DWI school or any substance abuse course, and (c) thereby incorrectly attends any part of the Level I course, will (when this situation is discovered) be required to attend a Level II course at the additional charge of $425.5.
All clients will be scheduled for class within a reasonable length of time. All clients are scheduled on a first come first served basis.
3. EVALUATION
All clients enrolling according to Section 316.192 or 316.193, F.S., or at the direction of the sentencing court or the DHSMV, shall be evaluated by an evaluator who is certified by the DUI Section, DHSMV, Tallahassee, FL. The purpose of the evaluation is to determine the existence of a possible substance abuse problem. DO NOT BRING CHILDREN TO THE EVALUATION APPOINTMENT, OTHERWISE YOUR APPOINTMENT WILL BE RESCHEDULED WITH A RESCHEDULING FEE OF $75.00.
4. REFERRALS
If you are referred to treatment as a result of the evaluation, you must contact the treatment agency within 20 days of the referral date. Failure to make contact with the treatment agency within 20 days of the date referred or failure to complete the required treatment may result in cancellation of the driving privileges by the DHSMV. All treatment costs shall be the responsibility of the client.
5. CONFIDENTIALITY
Your records are protected under the federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 CFR Part 2, and cannot be disclosed without written consent unless otherwise provided for in the regulations. You may revoke this consent at anytime except to the extent that action has already been taken. Boca Bay DUI Program, Inc. is required to report to the Judiciary (including Probation Department) and DHSMV regarding your completion/non-completion. This is not a violation of your confidentiality.
6. CLASS ATTENDANCE POLICY
Class will start promptly at the time assigned. ABSOLUTELY NO ONE WILL BE ADMITTED AFTER THE ASSIGNED TIME. No one will be allowed to ATTEND CLASS OR EVALUATION WITH ANY AMOUNT OF ALCOHOL OR CONTROLLED SUBSTANCE IN HIS/HER BODY. It is advisable not to use mouthwash within 30 minutes of class starting. If you fail to appear for any of your scheduled classes or evaluation, or if you are dismissed, you must personally come to this office Monday - Friday 9am to 5:30pm and be reassigned. Applicable fee must be paid at this time.
No rescheduling by TELEPHONE. You must reschedule more than 72 HOURS prior to assigned class/evaluation or pay a rescheduling fee.

**Attending the class or evaluation with ANY AMOUNT OF ALCOHOL or illegal drug in your body will result in FULL REPAYMENT OF FEES.

Client"s Initials
7. COURSE COMPLETION
If you are enrolling into the DUI Program (pre-conviction, court ordered, or as a requirement of the DHSMV) you are required to complete the educational and evaluation requirements within 90 days of enrollment. The “Certificate of Completion” will be issued following successful completion of the course and evaluation.

Failure to complete the program within 90 days of the initial enrollment date may result in the cancellation of the driving privileges by the DHSMV and will result in payment of the full enrollment fee to re-enroll in the DUI Program, including the class and evaluation.

The "Certificate of Completion" will be issued following successful completion of the course and evaluation. The certificate is issued upon the condition that any prescribed treatment must be completed. Failure by the client to remain in and complete treatment may result in cancellation of their driver license or permit by the DHSMV, Division of Driver Licenses.

If you are enrolled in the DUI Program and the DUI offense is subsequently nolle prossed, dropped, or otherwise dismissed, but the Administrative Suspension remains valid, you must still complete the DUI Program within 90 days of enrollment.
If you are enrolled in the DUI Program and subsequently found not guilty at trial of the DUI offense and the Administrative Suspension is invalidated, completion of DUI school will not be required, but the DUI Program must still report your enrollment and/or failure to complete to the DHSMV.
8. COURSE DESCRIPTIONS
DUI Level I course (12 hours): first time course in alcohol/substance abuse including instruction, information, and interactive educational methodologies. Required course for clients enrolling as a first offender.
DUI Level II course (21 hours): multiple offender course in alcohol/substance abuse with the primary emphasis on the special problems of the repeat offender using interactive educational techniques in a group setting.
9. PAYMENT OF FEES
Full payment of fees shall be made in CASH OR MONEY ORDER at the time of enrollment.
ALL FEES ARE NON-REFUNDABLE.

**
For Level ____ Fees
10. FEE SCHEDULE Client"s Initials

DUI Level I Course and Evaluation $287.50**

DUI Level I Rescheduling Fees:

1st reschedule 2nd reschedule 3rd reschedule

Class $40.00 $75.00 $153.00 (if within 90 days)

Evaluation $75.00 $153.00 (if within 90 days)

DUI Level II Course and Evaluation $432.50**

DUI Level II Rescheduling Fees:

1st reschedule 2nd reschedule 3rd reschedule

Class $60.00 $120.00 $238.00 (if within 90 days)

Evaluation $75.00 $153.00 (if within 90 days)

** Includes Driver Risk Inventory fee, Florida Driving Record fee

Miscellaneous:

Urinalysis Fee $40.00 Duplicate Completion Certificate $5.00

Transfer Fee (transfers are handled case by case) $15.00 Photocopy Fee $1.00 ea

      Referral to Another Treatment Agency $15.00

11. GRIEVANCE POLICY
Any student with a problem regarding Boca Bay DUI Program, Inc."s services is welcome to speak to the program manager at 954-449-4762.

Client Signature Date Witness Date
DUI003 (revised 5/1/2014)

(*) denotes a required field
1. Student Information   2. Payment Information  - CARDHOLDER's Name and Address
    Copy Student Information Below if SAME
Student First Name *   Credit Card First Name *
Student Last Name *   Credit Card Last Name *
Address *   Credit Card Address *
City *   Credit Card City *
State *   Credit Card State *
Zip Code *   Credit Card Zip Code *
County Where you Live, Work or Attend School *   Payment Amount  
Home Phone * -   Credit Card Number
VisaMastercardAmexOnly
*
How Did You Hear of Us? *   Expiration Date (mmyy) *
Email Address *   Credit Card Verification Code *
The following information is secured and required by the State to upload your data to the Florida Department of Highway Safety and Motor Vehicles:  

Level I registration for first time offenders who have never attended DUI school is $287.50. Level II registration for multiple offenses or previously attended DUI School is $432.50.

Gender *   3. Student Agreement
Date of Birth (mm/dd/yyyy) *  
The student named on this screen consents to the enrollment and participation requirements of the DUI program.  The student also understands and agrees:
  • That all fees payable to Boca Bay DUI are non-refundable, even if found not guilty of the DUI and the administrative suspension is invalidated.
  • That a BAC test may be administered prior to every class.
  • That the program must be completed within 90 days of this enrollment.
  • That the student has reviewed and accepted the State Requirements and Fees below.
Additional State Requirements -
Boca Bay DUI Program, Inc.
DUI SCHOOL · DRUG ALCOHOL TRAFFIC EDUCATION · DRIVER IMPROVEMENT
1. ENROLLMENT
DUI clients must enroll in person at the Boca Bay DUI Program, Inc., 100 S Military Trail #19, Deerfield Beach, Florida. DUI enrollment hours are Monday through Friday 9am to 5:30pm and Saturday 10am to 2pm.
Boca Bay DUI Program, Inc. may refuse to enroll anyone who is unwilling to comply with the rules and procedures of the program, or who is unwilling to make full disclosure for the purpose of evaluation.
Boca Bay DUI Program, Inc. and its clinical staff are certified by the Department of Highway Safety and Motor Vehicles DUI Programs Section.
2. CLASS PLACEMENT
All first offenders enrolling according to Section 316.192 or 316.193, F.S., shall be placed in the DUI Level I course.
Clients who have previously been convicted for driving under the influence, or have previously been ordered to, or have attended a DUI course, shall attend the DUI Level II course.
Boca Bay DUI Program, Inc. personnel will check each client"s arrest and driving records. Any client who (a) fails to report a prior DUI/DWI offense (including any DUI/DWI charge later reduced to Reckless or Careless Driving), or any DUI/DWI charge by the U.S. military or other government agency or any state other than FL, or (b) fails to report previously attending any DUI/DWI school or any substance abuse course, and (c) thereby incorrectly attends any part of the Level I course, will (when this situation is discovered) be required to attend a Level II course at the additional charge of $425.5.
All clients will be scheduled for class within a reasonable length of time. All clients are scheduled on a first come first served basis.
3. EVALUATION
All clients enrolling according to Section 316.192 or 316.193, F.S., or at the direction of the sentencing court or the DHSMV, shall be evaluated by an evaluator who is certified by the DUI Section, DHSMV, Tallahassee, FL. The purpose of the evaluation is to determine the existence of a possible substance abuse problem. DO NOT BRING CHILDREN TO THE EVALUATION APPOINTMENT, OTHERWISE YOUR APPOINTMENT WILL BE RESCHEDULED WITH A RESCHEDULING FEE OF $75.00.
4. REFERRALS
If you are referred to treatment as a result of the evaluation, you must contact the treatment agency within 20 days of the referral date. Failure to make contact with the treatment agency within 20 days of the date referred or failure to complete the required treatment may result in cancellation of the driving privileges by the DHSMV. All treatment costs shall be the responsibility of the client.
5. CONFIDENTIALITY
Your records are protected under the federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 CFR Part 2, and cannot be disclosed without written consent unless otherwise provided for in the regulations. You may revoke this consent at anytime except to the extent that action has already been taken. Boca Bay DUI Program, Inc. is required to report to the Judiciary (including Probation Department) and DHSMV regarding your completion/non-completion. This is not a violation of your confidentiality.
6. CLASS ATTENDANCE POLICY
Class will start promptly at the time assigned. ABSOLUTELY NO ONE WILL BE ADMITTED AFTER THE ASSIGNED TIME. No one will be allowed to ATTEND CLASS OR EVALUATION WITH ANY AMOUNT OF ALCOHOL OR CONTROLLED SUBSTANCE IN HIS/HER BODY. It is advisable not to use mouthwash within 30 minutes of class starting. If you fail to appear for any of your scheduled classes or evaluation, or if you are dismissed, you must personally come to this office Monday - Friday 9am to 5:30pm and be reassigned. Applicable fee must be paid at this time.
No rescheduling by TELEPHONE. You must reschedule more than 72 HOURS prior to assigned class/evaluation or pay a rescheduling fee.

**Attending the class or evaluation with ANY AMOUNT OF ALCOHOL or illegal drug in your body will result in FULL REPAYMENT OF FEES.

Client"s Initials
7. COURSE COMPLETION
If you are enrolling into the DUI Program (pre-conviction, court ordered, or as a requirement of the DHSMV) you are required to complete the educational and evaluation requirements within 90 days of enrollment. The “Certificate of Completion” will be issued following successful completion of the course and evaluation.

Failure to complete the program within 90 days of the initial enrollment date may result in the cancellation of the driving privileges by the DHSMV and will result in payment of the full enrollment fee to re-enroll in the DUI Program, including the class and evaluation.

The "Certificate of Completion" will be issued following successful completion of the course and evaluation. The certificate is issued upon the condition that any prescribed treatment must be completed. Failure by the client to remain in and complete treatment may result in cancellation of their driver license or permit by the DHSMV, Division of Driver Licenses.

If you are enrolled in the DUI Program and the DUI offense is subsequently nolle prossed, dropped, or otherwise dismissed, but the Administrative Suspension remains valid, you must still complete the DUI Program within 90 days of enrollment.
If you are enrolled in the DUI Program and subsequently found not guilty at trial of the DUI offense and the Administrative Suspension is invalidated, completion of DUI school will not be required, but the DUI Program must still report your enrollment and/or failure to complete to the DHSMV.
8. COURSE DESCRIPTIONS
DUI Level I course (12 hours): first time course in alcohol/substance abuse including instruction, information, and interactive educational methodologies. Required course for clients enrolling as a first offender.
DUI Level II course (21 hours): multiple offender course in alcohol/substance abuse with the primary emphasis on the special problems of the repeat offender using interactive educational techniques in a group setting.
9. PAYMENT OF FEES
Full payment of fees shall be made in CASH OR MONEY ORDER at the time of enrollment.
ALL FEES ARE NON-REFUNDABLE.

**
For Level ____ Fees
10. FEE SCHEDULE Client"s Initials

DUI Level I Course and Evaluation $287.50**

DUI Level I Rescheduling Fees:

1st reschedule 2nd reschedule 3rd reschedule

Class $40.00 $75.00 $153.00 (if within 90 days)

Evaluation $75.00 $153.00 (if within 90 days)

DUI Level II Course and Evaluation $432.50**

DUI Level II Rescheduling Fees:

1st reschedule 2nd reschedule 3rd reschedule

Class $60.00 $120.00 $238.00 (if within 90 days)

Evaluation $75.00 $153.00 (if within 90 days)

** Includes Driver Risk Inventory fee, Florida Driving Record fee

Miscellaneous:

Urinalysis Fee $40.00 Duplicate Completion Certificate $5.00

Transfer Fee (transfers are handled case by case) $15.00 Photocopy Fee $1.00 ea

      Referral to Another Treatment Agency $15.00

11. GRIEVANCE POLICY
Any student with a problem regarding Boca Bay DUI Program, Inc."s services is welcome to speak to the program manager at 954-449-4762.

Client Signature Date Witness Date
DUI003 (revised 5/1/2014)
Social Security Number
(If you have no SSN, Enter 000000000)
*
Florida Driver License # *
Out of State Driver License #
(Only if you have no Florida DL)
*
DL# State if Not Florida *
Number of Previous DUIs *
Have you ever attended DUI school in the past? *
State of Current DUI Arrest *

The student has reviewed all statements made on this screen and agrees that they are true and correct.

Note: Payment Authorization may take up to a few minutes depending on your connection. To avoid being charged twice DO NOT abort the transaction, close the page or press the Process Payment button twice. When the authorization completes, you will be automatically taken to the Receipt Page.