COASTAL BEND REGIONAL
COURT RESIDENTIAL TREATMENT CENTER
800 N. VINEYARD
SINTON, TEXAS 78387
(361) 364-4323
Counties
Aransas
Bee
Live Oak
McMullen
San Patricio
36th, 156th, 343rd
District Courts
To: Community Supervision and Corrections Departments
Thank you for your interest in the Coastal Bend Regional Court Residential Treatment Facility.
Enclosed is a Referral Packet Checklist for placement in our program.
Please submit the documents on the Referral Packet Checklist to review eligibility to our program. All
information must be received to complete the screening process and placement. If your counties’
Community Supervision and Corrections Department does not provide our assessments listed in Referral
Packet Checklist, we will consider similar screening tools comparable to our assessments.
If you have any questions or need further assistance in completing the Referral Packet Checklist, please
contact me.
Sincerely,
Linda Diaz, Ph.D., LPC-S
Director of Residential Services
Coastal Bend Regional
Court Residential Treatment Center
800 N. Vineyard Avenue
Sinton, Texas 78387
Office: (361) 364-4323, Ext. 11
Fax: (361) 364-2768
Email: ldiaz@sanpatriciococscd.org
Form.012
09/11
36th, 156th, and 343rd JUDICIAL DISTRICTS
COMMUNITY SUPERVISION AND CORRECTIONS DEPARTMENT
Coastal Bend Regional Court Residential Treatment Center
Sinton, Texas
After the case has been staffed and determined appropriate for the CRTC, a packet will be prepared to
include the following information (submit two copies). Separate packets to be submitted for the treatment and
employment phase of the program. If not applicable indicate N/A.
CRTC
Defendant’s Name:
Intra-State Transmittal Form (out of county only)
Supervision Plan
Current Photograph
Uniform Referral Form
Personal Data Sheet
Judgment; Conditions; Orders Amending; MTRs; Orders Continuing
CJAD Risk Needs Forms
Texas Uniform Health Status Form
Offense Report
Criminal History
Alcohol/Drug History (Dopers), SAE, SAI
Mortimer-Filkens (Questionnaire & Interview) – Alcohol Driving Offenses Only
WRAT
SASSI (for other than alcohol driving offenses)
MMPI
Psychological, SCS, PSI (if available)
Urinalysis results
TB Test results (skin tests may be submitted positive but admission screening will not be
conducted until x-ray and a clean medical report are received)
MUST ATTACH COPIES OF THE FOLLOWING:
Drivers License or Texas ID or Birth Certificate
Department Financial Status Report
Social Security Card
Assigned Supervision Officer:
Supervisor at Staffing:
Date of Staffing: