CES Referral Form

Submission Date

Date

Referral Date

Date

Client Name

First NameLast Name

Client's Date of Birth

Date

Offense

Cause Number

Who is filling out this referral form?

Other (i.e. CA, DA, DRO, self, etc.)

Attorney Name

Probation Officer Name

Name

Email

example@example.com

Comments

File Upload

Which Counseling & Education Services are needed?

For Family Violence (FV Assessment) or Violence Assessment (NIPV):

Call (512) 854-9540 to begin the assessment process.

No appointment necessary to complete the assessment paperwork. Upon completion of paperwork, CES Staff will contact you for further directions on how to complete the assessment.

The assessment with the licensed counselor takes approximately 2 ½ to 3 hours.

Cost of assessment is $55.00 due at the time of assessment.

For Alcohol and Other Drug (AOD) Assessment

(This assessment only assesses for substance use and does not assess for violence):

Call (512) 854-9540 to begin the assessment process. No appointment necessary to complete the assessment paperwork. Upon completion of paperwork, CES Staff will contact you for further directions on how to complete the assessment.

The assessment with the licensed counselor takes approximately 2 to 3 hours.

Cost of assessment is $55.00 due at the time of assessment.

Which type of Counseling and Education Services Classes are needed

Please select which alcohol/drug classes are needed

Please select which adult education classes are needed

*This class requires a prosecution and defense agreement. Please send agreement to Ces.Mail@traviscountytx.gov

Please select which youth classes are needed

Applicable fees are due at the time of assessment or class registration. Payable only by Credit Card (3% Processing Fee), Money Order or Cashier's Check made out to CES.

No personal checks or cash will be accepted.

In submitting this referral form, I understand that it is the client’s responsibility to know that fees are due at the time of the assessment or class registration and only payments made with credit card, money order, or cashier's check will be accepted.

Location Address

5501 Airport Blvd., Suite 102 Austin, TX 78751(Map)

Directions

From North Austin:

Take IH-35 South (south bound). Take the 51St Street exit. When you get to 51st street take a right, you will continue until you get to Airport Blvd. When you get to Airport Blvd take a right, continue until you pass 53rd street. Once you pass the light at 53rd street you will see the Travis County Building on your right hand side. Counseling & Education Services is in Suite #102.

From South Austin:

Take IH-35 North (north bound). You will need to take the upper deck where IH 35 splits. Take the Airport Blvd. exit. When you get to Airport Blvd take a left, continue about 1 mile until you pass 53rd street. Once you pass the light at 53rd street you will see the Travis County Building on your right hand side. Counseling and Education Services is in suite #102.

Travis County Counseling & Education Services Referral Form

Counseling and Education Services (CES)

CES Classes Offered

Payment Information

How to Get to the Service Center