The Center for Cognitive Education, LLC.
503 South Main Street, Georgetown Texas, 78626
Phone 512-868-9644 Fax 512-868-2644
Email: info@theccedu.org Web site: www.theccedu.org
Williamson County Referral Form
Revised 3-6-13
DATE OF REFERRAL:__________ CLIENT NAME: __________________________________________
REFERRAL SOURCE NAME/TITLE/CONTACT INFORMATION:
______________________________________________________________________________________________
The Center for Cognitive Education offers programs/services with non-traditional hours (evenings/weekends). Programs/services
listed are also offered in Bell, McLennan, and Travis Counties. For additional information, please refer to our web site,
www.theccedu.org, or send an email to info@theccedu.org .

Client’s, DO NOT call to register for Programs #1- #3, just follow the Orientation schedules listed below. If
you miss your scheduled Orientation date show up the following week on the same day/time. For
Programs #4- #6, please follow the specific program email instructions provided.
INSTRUCTIONS for Referring Agency on Programs #1- #3: Please mark the number/letter of the program(s) that
the client is being referred to. Provide the completed form to the client and advise them to be at the above address on
the date/time you specified. Email (or fax) the completed Referral Form to Angela De La Rosa,
adelarosa@theccedu.org. Client will be placed on the appropriate program roster. You will be advised of program
attendance/group facilitator name. Advise client of program costs. Cash/money order, please. Checks not accepted.
Receipts provided upon payment.
1. Cognitive Education Programs (CEP) & NIPV Orientation. Date to Attend: TUESDAY
,
Time 8:00pm. Orientation for all of the following CEP and NIPV programs does include: view of basic cognitive
concepts; view of program structure; the client being assigned a weekly class; and purchasing workbook. $20 is
required at the Orientation ($15 for orientation and $5 for manual). Mark type of CEP client is to enroll in:
a. _____ Basic Cognitive Self Change: 8 weekly class sessions; $25 per weekly 1 ½ hour class. Please specify
type of class: ______ Substance Abuse Emphasis; ______ General.
b. _____ Advanced Cognitive Education: 22 week program; $15 per weekly 1 hour class. Please specify type
of class: ______ Substance Abuse Emphasis; ______ General.
c. _____ Diversion Cognitive Education (Pre Trial Intervention clients ONLY): 10 week program; $15 per
weekly 1 hour class. Please specify type of class: ______ Substance Abuse Emphasis;_____ General.
d. _____ Spanish Cognitive Self Change Program: $15 per weekly 1 hour class. Individualized to meet client
needs of: ______ Cognitive Education; ______ Non Intimate Partner Violence; ______ Intimate
Partner Violence. Date to begin: Monday _____________, Time 8:00pm ($20 required at 1st class.
$15 for class/$5 for workbook).
2. Non Intimate Partner Violence (NIPV) Program Orientation. Date to Attend: TUESDAY
,
Time 8:00pm. ‘Anger management’ program ONLY appropriate for offenses involving violence between
strangers, roommates, adult siblings, parent/adult child, in-laws, and neighbors. Program lengths address the
identified risk/needs of the client. Offenses involving violence between intimate partners are not appropriate for
this program and need to attend the “Intimate Partner Violence Program”. $20 is required at the Orientation
($15 for orientation and $5 for manual). Mark type of NIPV client is to enroll in:
a. _____ 8 weeks/ 12 hours. 1 ½ hour weekly class sessions; $20 per class.
 Basic ‘1st time offenders’. No previous history of violence or substance abuse behaviors.
b. _____ 16 weeks/ 24 hours. 1 ½ hour weekly class sessions; $25 per class.
 History of substance abuse behaviors, but no previous history of violence.
c. _____ 22 weeks/ 33 hours. 1 ½ hour weekly class sessions; $25 per class.
 History of violence and substance abuse behaviors.
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The Center for Cognitive Education, LLC.
503 South Main Street, Georgetown Texas, 78626
Phone 512-868-9644 Fax 512-868-2644
Email: info@theccedu.org Web site: www.theccedu.org
3. Intimate Partner Violence Program (IPV) Orientation. Date to Attend: THURSDAY
7:45pm.
This program is ONLY appropriate for offenses involving violence within an intimate partner relationship
(husband/wife, boyfriend/girlfriend, ex-husband/ex-wife, etc). Focus is placed on taking accountability for the
battering behavior with the goal of stopping future acts of violence. Orientation for IPV and BIPP does involve
the client being assigned to a permanent weekly class, purchasing of program manual, reviewing/signing program
agreement, and program overview. $40 required at time of Orientation ($20 for orientation and $20 for
manual). Please mark the length of IPV program client is to enroll in:
a. _____ 12 weeks (18 hours); 1 ½ hour weekly class sessions; $20 per class. Condensed version of BIPP.
(NOT approved for clients on probation or parole)
b. _____ 24 weeks (36 hours) Battering Intervention and Prevention Program (BIPP); Accredited by TDCJCJAD as an approved BIPP provider; 1 ½ hour weekly class; $25 per class.
4. Conflict Resolution and Anger Management Program: 6 hours of class instruction (2 days a week) 6:00pm9:00pm each day, with 2 hours of homework assignments. Total of 8 hours. Cost: $85. Email Instructions:
Subject line titled with Last name, First initial and “CRAMP”. Email to include the class date you are registering
for, your full name & contact number and send to info@theccedu.org. 2013 dates: Jan 9th/16th; Feb 6th/13th; Mar
6th/13th; Apr 3rd/10th; May 1st/8th; Jun 5th/12th; Jul 10th/17th; Aug 7th/14th; Sept 4th/11th; Oct 2nd/9th; Nov 6th/13th; Dec
4th/11th. (NOT approved for persons on parole supervision; and, Clients with a current or past offense of violence
between intimate partners are not appropriate for this program and need to attend the Intimate Partner Violence
Program).
5. Money Management/Theft Prevention Program: 6 hours of class instruction (2 days a week) 6:00pm- 9:00pm
each day, with 2 hours of homework assignments. Total 8 hours. Cost: $85. (*Probation funded cost = $15)
Email Instructions: Subject line titled with Last name, First initial and “MMTP”. Email to include the class date
you are registering for, your full name & contact number and send to info@theccedu.org. 2013 dates: Jan
13th/16th; Feb 17th/20th; Mar 17th/20th; Apr 21st/24th; May 19th/22nd; Jun 16th/19th; Jul 21st/24th; Aug 18th/21st; Sept
15th/18th; Oct 20th/23rd; Nov 17th/20th; Dec 15th/18th.
6. Drug and Alcohol Urinalysis Screening: are conducted on a “walk-in” basis every Tuesday and Thursday
between 8:30 am and 12:30 pm at 503 Main St, Georgetown. There is no need to call to schedule. The fee is
$50 cash or money order. You will be provided with a receipt and a copy of your results at the time of testing.
This process generally takes 15 to 20 minutes. Please bring a photo ID.
7. Pre – Disposition Substance Abuse Evaluations and Risk Assessments: (Not for Pre-Trial Intervention)
Email Instructions: Subject line titled “Pre-Disp Eval”, then your Last name, First initial. Email to include your
full name/contact number and send to info@theccedu.org . You will be contacted to schedule a day/time for your
evaluation. Evaluations are conducted at 503 Main St, Georgetown and generally take 1 ½ hours. These
evaluations are designed to provide information to Attorneys and the Courts to assist with decisions associated
with disposition of a case. Costs: Substance Abuse Evaluation only = $100 ; Substance Evaluation and
Level of Service Inventory Revised (LSIR – risk and needs assessment) =$150 . A drug screening is also
recommended to support the findings of the Substance Abuse Evaluations. Drug and Alcohol screenings are
available for $50. Payment is due at the time of your screening and/or evaluation in the form of cash and/or
money order. A receipt will be provided at the time of payment. With your consent, a written report reflecting the
screening results and/or the evaluation summary will be made available to the Courts and/or your Attorney.
Please bring a photo ID.
DIRECTIONS: Traveling North or South on I-35 to Georgetown, take the “Highway 29 Burnet/Taylor” exit. Travel East on
Highway 29/University Drive (toward the downtown area). Turn left on Main Street, which is the 1 st stoplight after S. Austin
Avenue. Travel past the old courthouse and continue towards East 5 th Street. The Center for Cognitive Education is located on the
corner of Main Street and East 5th Street (grey, 2 story building). Parking is available along the sides of the streets and behind
building. Do not park within the “Tamiro Building” parking lot that is also located on Main Street and East 5 th due to risk
of being towed.
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