Drug And Alcohol Assessment Referral (Daar) Form
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1Interpreter required
Bail – Adj. Date:
/
/
Referral number
Court location
Recognisance
Language:
DC
________________
_______________
Amount: $
Length:
month/s
Wheelchair access required
____________/___ (__)
Stated date:
/
/
MAG-
Drug and Alcohol Assessment Referral (DAAR) Form
Bail Act 1980 – Section 11AB
Penalties and Sentences Act 1992 – Section 19(1)(2B)
Defendant’s Details:
Surname: ____________________________Given name(s): ___________________________M
F
Address: _______________________________________________________________State:
__________
Postcode: _____________________________Mobile No:
_______________________________________
Email:
________________________________________________________________________________
D.O.B:
__________/_________/________
Place of birth:
_________________________________________
Identifies as:
Aboriginal
Torres Strait Islander
Suitability:
1. Was the defendant 18 years or over at the time of the offence?
YES
NO
Note: If you have answered “no” to question 1, a DAAR course condition can only be imposed
subject to a Recognisance Order pursuant to s.19(1)(2B) of the Penalties and Sentences Act 1992
2. Was your alcohol and/or drug use directly associated with your offending behaviour? YES
NO
3. Do you currently have pending, or have you previously been convicted of, an offence
of a sexual nature or an offence involving violence (excluding s.335, s.340(a) or
s.340(b) of the Criminal Code Act 1899)?
YES
NO
Note: If you have answered “yes” to question 3, a DAAR course will be conducted by telephone.
_______________________________________________________________________________________________________________________
4. DAAR Coordination Service will advise the following:
Previous DAAR course
YES
NO
If yes, dates of courses completed
_______________
Note: The defendant is ineligible for the DAAR session, if they have completed two (2) DAAR sessions within the
previous 5 years.
The abovenamed defendant is
Eligible
Not eligible to complete a DAAR course.
If eligible, DAAR course to be conducted
In person
Telephone
DAAR Course Provider:
__________________________________________________________________________
Address/Phone No.:
_____________________________________________________________________________
Day:
_________________________
Date:
___________________________
Time:
________________________
_______________________________________________________________________________________________________________________
Defendant’s Consent: The DAAR process has been explained to me and I agree to attend the session
arranged on my behalf. I also agree to notify the DAAR office by telephone on (07) 3836 0677 prior to the
scheduled session if, for any reason beyond my control, I am unable to attend the DAAR session.
I understand that the Department of Justice and Attorney-General is collecting my personal information on this
form to assess my eligibility to participate in a DAAR session under either the Bail Act 1980 or the Penalties and
Sentences Act 1992. It is the department’s usual practice to disclose this information to the DAAR Coordination
Service as part of the program to obtain the DAAR session venue and date.
I authorise the relevant DAAR session provider to disclose to the DAAR office in Brisbane information about my:
(i)
attendance at and completion of the program; or
(ii)
failure to attend or complete the program, if I fail to attend or complete the program.
Signed:
____________________________________________
Date:
___________________________
A COPY TO BE GIVEN TO THE DEFENDANT, ONE TO THE COURT, AND EMAIL A COPY TO
THE DIVERSION & REFERRAL SERVICES OFFICE - DAAR@justice.qld.gov.au
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