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DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS DRIVINGUNDERTHEINFLUENCE (DUI) PROGRAM 3MONTH PROGRAM (30 HOURS) QUARTERLY LICENSING AND PARTICIPANT ENROLLMENT REPORT INSTRUCTIONS: This form is to be used

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What is part 1 - provider?

Part 1 - provider is a section of a form or document that specifies information about the service or individual providing services.

Who is required to file part 1 - provider?

Any individual or entity that is providing services and is specified to do so in the form or document.

How to fill out part 1 - provider?

Part 1 - provider can be filled out by providing all the necessary information about the service provider as required by the form or document.

What is the purpose of part 1 - provider?

The purpose of part 1 - provider is to accurately identify the service provider and provide necessary information for record-keeping and legal purposes.

What information must be reported on part 1 - provider?

Information such as name, address, contact information, and services provided must be reported on part 1 - provider.

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