200-00630 – Pretrial Services Court Order (10/2019) Page 1 of 1
DOB
PRETRIAL SERVICES COURT ORDER
The Court orders the Defendant to meet with the Pretrial Services Coordinator and
:
☐
participate in a needs screening with the Pretrial Services Coordinator.
☐
participate in a mental health clinical assessment
and follow the recommendations of the clinical
treatment provider.
☐
participate in a substance use clinical assessment
and follow the recommendations of the clinical
treatment provider.
☐
engage in Pretrial Services and work with the Pretrial Services Coordinator.
Date
_____________________________ _____________________________________
Superior Court Judge
I have received a copy of this Order. I have read it. I understand it.
Dated/Time
_____________________________ _________________________________________
Signature of Defendant
_________________________________________
Street Address
_________________________________________
City, State, Zip
__________________________________________
Phone
☐ No next hearing date set at the time this Order is issued.
☐ Next scheduled Court date: _______________ at _______________ at ___________________________.
date time court location
cc: Sta
te’s Attorney/Attorney General
Defendant/Defense Attorney
Pretrial Services Coordinator
