Order For Community Residential DOSA Screen And Pre Sentence Examination {CR 84.0320}

Superior Court of Washington County of State of Washington, Plaintiff, v. ____________________________________, Defendant. DOB: PCN: No. Order for Community Residential DOSA Screen and Pre-Sentence Examination per RCW 9.94A.660 (ORDOSA) Offense: _________________________ The court will consider imposing a sentence under the Residential Chemical Dependency Treatment-Based Alternative sentence (DOSA). It is hereby Ordered that the Defendant shall participate in a chemical dependency screening report and pre-sentence examination with a DOC contracted provider. It is further Ordered that sentencing in this case shall occur on ____________, 20___, at ____am/pm before Judge ______________________ in Room _______ of the ____________________________County Courthouse. It is further Ordered that within 10 days of receiving this order the examination report shall be faxed or delivered to the Court at (fax number or room number): _________________, to the Prosecuting Attorney at (fax number): _______________________, to the Defendant (or Defense Counsel) (fax number): _______________________, and to the Department of Corrections Headquarters CD Unit. [] [] [] [] Defendant is residing in the community. Defendant's name, address and telephone number are: ___________________________________________________________________________. Defendant is incarcerated at: ___________________________________________________. Defense counsel's name and address are: __________________________________________ ___________________________________________________________________________. [ ] Prosecuting Attorney [ ] Defense Attorney will send this order to Department of Corrections at: docdosascreening@doc1.wa.gov or FAX: 360-586-0039. ________________________________________ Judge __________________________ Defendant Print Name: Dated: ______________________________ Presented by: ___________________________ ___________________________ Deputy Prosecuting Attorney Attorney for Defendant WSBA No. WSBA No. Print Name: Print Name: Or For Comm. Res. DOSA Screen and Pre-Sent. Exam. (ORDOSA) Page 1 of 1 CR 84.0320 (10/2015) RCW 9.94A.660 American LegalNet, Inc. www.FormsWorkFlow.com