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What to bring

Valid form of ID

Alcohol/Drug Uniform Report if applicable

Driving Record

It needs to be a driving abstract issued for court purposes and cannot be older than 30 days.

 

Report from DUI Arrest

You will need the report from the night of the arrest. Depending on where your DUI took place, this document may be called the notice of summary suspension, sworn report, law enforcement report, or police report. It should include: date of arrest, time of arrest, and the results of a breathalyzer test or a drug test.

 

Consultation Checklist

This is only for drivers who hold a driver’s license from Illinois. It is needed for license reinstatement evaluations.

What is required for the DUI evaluation process

A current drivers abstract
The Statutory Summary Suspension and or Law Enforcement Sworn Report
A brief interview (in person or on the phone) with a family member or friend.
Treatment documents (if completed prior to the evaluation)
A copy of denial order or orders, if you have been previously denied driving relief.

The evaluation typically takes 1.5 to 2 hours. During that time, we will review your documents, interview you regarding your drug and or alcohol use history, and administer a computer based objective test. The results will be discussed after completion.

What information can be found in my health record

health record is created any time you see a health professional such as a doctor, nurse, dentist, chiropractor, or psychiatrist. You could find the following in your health record:

  • Your medical history and your family’s medical history
  • Labs and x-rays
  • Medications prescribed
  • Alcohol use and sexual activity
  • Details about your lifestyle (smoking, exercise, recreational drug use, high-risk sports, stress levels)
  • Doctor/nurse notes
  • Results of operations and proceduresGenetic testing
  • Research participation
  • Any Information you provide on applications for disability, life or accidental insurance with private insurers or government programs
  • Driver’s License
  • Social Security Number
  • Financial information such as credit cards and payment info

Who has access to my health records

Many more people than you would ever want, including people outside the health care industry.

  • Insurance companies
  • Government agencies especially if you receive Medicare, Medicaid, SCHIP, SSI, Workers Comp or any local, state or federal assistance
  • Employers
  • Banks, Financial Institutions
  • Researchers
  • If you are involved in a court case, your health records can be subpoenaed and available to the public
  • Marketers
  • Drug companies
  • Data miners
  • Transcribers in and outside the U.S.
  • Many health websites collect information about you

Can my personal health information be used and disclosed without any notice to me or without my informed consent at the time of treatment

Yes.

The Amended HIPAA Privacy Rule states only that you must receive a Privacy Notice telling you how your personal health information will be used and disclosed. Section 164.520(c) (2) (i) (A).
Privacy Notices are often mistaken for consent forms, but they are simply notices telling you what will happen to your medical records.

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