Statement of Fact Request

Statement of Fact

This form is to be used to submit written permission to be excused from any program requirements, leave the county, or to document your recollection of any events that may have been misunderstood between you and the Drug Court Team. The following is an opportunity for you to provide to the Drug Court Judge your own statement on the situation and circumstances surrounding the request. 

Choose the applicable dates below. If on a phone, you should get a calendar pop up to pick the date. If it does not work on your phone, enter the dates in the explanation field at the end. The default date is today's date.

Group Sessions Individual Session Support Meeting Missed UA Missed Group Missed 1 on 1 Missed Court Other - Explain Below

***This Form must be submitted by 5pm on Thursday for a weekend request ***

(Your financial status on Drug Court payments will be a factor in considering approval).

By checking this box I certify I am the person named and that the above is true and correct.

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TELEPHONE: (360) 577-3085
FAX (360) 414-5506
TTY (800) 883-6388 OR 7115

KELSO, WA 98626
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