Adult Probation Forms

Welcome to the Court Services Department Adult Probation Forms page!

We are pleased to announce that you now have the ability to print a variety of forms.

• A. A. Program Attendance
• Admission of Use Form
• Adult Intake Review
• Alpharus (formerly Gateway) Release of Information 
• Assessment Summary Worksheet
• Authorization for Lutheran Child and Family Services of Illinois to Release Information
• Authorization for Release of Shared Information
• Central Counties Release of Information
• Community Resources
• Consent to Participate in Audio Taping
• Core Correctional Practices (CCP) Authorization to Audiotape Form 
• Core Correctional Practices (CCP) Feedback Form 
• Core Correctional Practices (CCP) Feedback Form Proficiency Rating Definitions
• CST Interview Guide
• DCFS Consent for Release of Information
• DCFS Written Confirmation of Suspected Child Abuse-Neglect Report-Mandated Reporter
• DHS Authorization to Disclose-Obtain Information
• DVI Answer Sheet
• Family Guidance Centers Authorization for Disclosure of Health Information
• Authorization to Disclose Mental Health Treatment Information
• Family Service Center Probation Referral For Anger Management
• Financial Status Fact Sheet - Probation Fee Assessment Worksheet
• IDOC Authorization for Release of Offender Mental Health or Substance Abuse Treatment Information
• IDOC Authorization for Release of Offender Medical Health Information
• Illinois Murderer and Violent Offender Against Youth Registration Act Notification Form
• Illinois Sex Offender Registration Act Notification Form
• Intrastate Transfer Form
• ISP DNA Indexing Database Sample Receipt Form
• Memorial Behavioral Health HIPAA Authorization To Use and Disclose Health Information
• Memorial Hospital HIPAA Authorization To Use and Disclose Health Information
• Monthly Audit Form
• Monthly Pretrial Audit Form
• Monthly Workload Report
• Motion for Conditional Waiver of Probation Fee
• Motion to Modify
• Motion to Modify - DNA Waiver
• Motion to Modify Interstate Probation Fees
• Payment Instructions (2 Per Page)
• Revised Pretrial Virginia Risk Assessment Instrument
• Pretrial Interview Rights
• Probation Fee Assessment
• Probation Fee Schedule (Notification of Changes)
• Probation Fee Schedule Form (Notification of Changes) Instructions to Complete (Transferring Jurisdiction)
• Probation Fee Schedule Form (Notification of Changes) Instructions to Complete (Receiving Jurisdiction)
• Probation Fee Schedule Form (Notification of Changes) Instructions to Complete (Re-Evaluation by Supervising Jurisdiction)
• Probationers as Informants Form
• Probationers as Informants Letter
• Probationer's Monthly Report
• PSI Investigation - Intake Questionnaire
• PSI Mid-Term Review
• Public Service Employment Handout
• Public Service Employment Time Sheet
• Public Service Employment Handout - Deferred Prosecution
• Release for Sangamon County Sheriff's Dept. Records
• Request Pertaining to Military Records
• SIU School of Medicine Authorization for Release of Confidential Medical Information
• Social Security Administration Consent for Release of Information
• Springfield Clinic Authorization to Release Medical Information
• Springfield Clinic Behavioral Health - Authorization to Disclose Patient Information Documents
• St John's Hospital Authorization for Disclosure of Health Information
• Supervision Condition Verification Letter
• TASC Adult Intake Interview Referral and Demo
• TASC Court Referral Signature Sheet
• Transfer Fee Assessment
• Urinalysis Results, Breath Testing and Medication Record
• VA Request for Authorization to Release Health Information