New York State Department / Department of Motor Vehicles / New York State office of Alcoholism and Substance Abuse Services / Treatment Agency / Drinking Driver Program Agency / /
Position
Director It of Agency / Drinking Driver / Motor Vehicles DRINKING DRIVER / /
New York State Department of Motor Vehicles DRINKING DRIVER PROGRAM CONSENT FOR RELEASE OF INFORMATION INSTRUCTIONS: Give a copy of this form to the participant. Programs must keep a copy of each signed form for six (6)