1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 I, respectfully petition the court for acceptance into treatment court. I understand treatment court programs are designed to coordinate services and interventions intended to rehabilitate court-involved individuals. Treatment court is not available to everyone due to limited resources and eligibility criteria. If this petition is accepted by the court, I agree to give up the following rights and to carry out the agreements set forth below: 1. I waive my right to have a preliminary hearing and/or grand jury indictment _________________________ Defendant State of Oregon vs CASE NUMBER: ______________ PETITION FOR TREATMENT COURT IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR JACKSON COUNTY and agree to proceed upon the District Attorney's information or indictment by entering a plea of guilty to the charge(s). I give up my right to have any evidence seized by police in this case tested by the Oregon State Crime Laboratory or any other entity. If this is a probation violation, I waive my right to a probation revocation hearing and will enter an admission to the allegation(s). 2. I understand if I successfully complete treatment court, I may receive a reduction or dismissal of the charges. If dismissed with prejudice, the District Attorney may not prosecute this charge in the future. If this is a probation violation, the probation may continue beyond my participation in treatment court. 3. I agree if I am terminated from the treatment court program, my case will proceed directly to sentencing. I will not be entitled to a hearing. If I received a suspended sentence, that sentence will be imposed without further delay and may include jail or Treatment Court Petition 01/25/17 Page 1 American LegalNet, Inc. www.FormsWorkFlow.com 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 penitentiary time. The same will be true if I am on a conditional discharge or have a deferred sentence. The State may request my termination from the treatment court for non-compliance at any time. The ultimate decision to terminate will be made by the court. 4. I agree that any violation of the terms of this agreement, commission of a new crime or any failure in the treatment program may result in modification of the treatment court agreement or termination from treatment court program and will then proceed to sentencing. I agree the court may impose other sanctions including, but not limited to, community service, work crew, court days, and jail, rather than terminating my participation in treatment court. 5. I waive the following rights: my right to a speedy trial before a jury of my peers, my right to call witnesses on my behalf, my right to confront any witnesses and my right to remain silent. If the District Attorney files additional charges arising from the original incident on which my plea is based, I agree not to assert my former jeopardy rights. I further agree not to file any motions, including motions to suppress any evidence obtained by search and/or seizure. I have discussed these waivers with my attorney and fully understand their significance. If I have signed this waiver without the assistance of an attorney, I acknowledge that I am aware I have the right to have an attorney, and if I cannot afford an attorney the court would appoint an attorney to assist me. 6. I agree to satisfactorily complete a diagnostic assessment for the development of my drug/alcohol treatment program at a state certified treatment provider, as ordered by the court. I authorize the release of all treatment information by the treatment provider to the court. 7. I agree to complete a treatment program which may be at my expense and to attend a minimum of two support groups (12 steps) per week unless otherwise ordered. I will follow and comply with all requirements of the treatment program. 8. I agree to comply with all requirements for drug testing. Any dilute, refusal, or failure to give a drug test will be considered a positive or dirty test. A positive or a dirty drug test will not necessarily terminate me from treatment court, but may lead to a sanction or recommendation by the treatment provider. I may be required to pay for drug testing. Treatment Court Petition 01/25/17 Page 2 American LegalNet, Inc. www.FormsWorkFlow.com 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 9. I understand I will be tested for all controlled substances. I may be tested for substances not currently illegal, but prohibited by my probation officer or the court. Any results out of range may be considered a positive test. The test will also screen for possible adulteration. If I submit a urine sample that appears to have been diluted or adulterated, I will be required to wait at the testing facility until a legitimate sample can be obtained. All tests are observed. Any dilute sample may be considered a positive test. 10. I agree to provide information on all prescriptions from my health care provider(s) that I am taking while in treatment court. If I do not provide these prescriptions, any test showing the presence of any drugs will be considered positive or a dirty. I understand I should explore non-narcotic prescription alternatives to narcotic medication. I will be required to inform medical personnel of my addictions prior to receiving narcotic medications. I understand I am not allowed to take prescription medication that has not been prescribed to me by my health care provider(s), nor am I allowed to abuse prescribed medication. 11. I understand that I may also be asked to take a polygraph as a condition of my participation in treatment court. I will also be required to pay for any polygraph test. 12. I shall refrain from knowingly associating with persons who use or possess controlled substances illegally or from frequenting places where such substances are kept or sold, including bars and taverns. 13 I agree to submit current private and/or government funded medical insurance information upon admission into treatment. I understand I will be required to show proof of income and apply for the Oregon Health Plan if I am eligible. I authorize release of all information necessary to appropriately invoice third party insurance plans for treatment services provided to me under this program. 14. I will immediately report all contact with law enforcement to a member of the treatment court team. 15. I will not wor