Free CR-168 - California

CR-168
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: FOR COURT USE ONLY

PEOPLE OF THE STATE OF CALIFORNIA

v.
DEFENDANT:

BATTERER INTERVENTION PROGRAM PROGRESS REPORT

CASE NUMBER:

Name and address of program:

Report date: Intake date: 1. ATTENDANCE a. Satisfactory

Reporting period: Class start date:

c. Classes attended: d. Excused absences: b.
Unsatisfactory (explain):

e. Classes made up: f. Unexcused absences:

b.

Unsatisfactory

2. PAYMENT OF FEES Satisfactory a.

3. PARTICIPATION (since last evaluation) Unsatisfactory (explain): Satisfactory a. b. 4. ITEMS EVALUATED (u = unsatisfactory s = satisfactory

a. b. c. d. e.

Cooperates Attentive Nonargumentative Participates Not Disruptive

f. g. h. i. j.

n/a = not applicable) Deals with anger/hostility Participates in alcohol or drug counseling (if required) Accepts responsibility vs. blame shifting Grasps gravity of behavior vs. minimizing Identifies and acknowledges issues vs. denying

5. PROGRESS EVALUATION and RECOMMENDATIONS is is not in compliance with program requirements. a. Individual has not met the basic minimum program requirements. b. Individual has c. The overall evaluation, including test results, indicates (1) Client should continue in program as originally ordered. (2) Client should be given additional time to make appropriate adjustments. (3) Client should repeat certain program sections (specify): 6. COMMENTS:

Date:
(TYPE OR PRINT NAME AND TITLE) (SIGNATURE OF PROGRAM PROVIDER) Page 1 of 1 www.courtinfo.ca.gov American LegalNet, Inc. www.FormsWorkflow.com

Form Approved for Optional Use Judicial Council of California CR-168 [New January 1, 2007]

BATTERER INTERVENTION PROGRAM PROGRESS REPORT