Underage Consumption Session : Agency Commitment Form

UCP Agency Commitment Form

UCP Agency Commitment Form

Form must be completed in order for attendance to be verified with referring agency.

Below are some strategies to help you lower your risk related to alcohol consumption. These ideas have worked well for other students, youth and young adults. Please check those you have tried or those that might be useful to you.

Style of Drinking
Settings and Risky Activities
Social Situations

This section of this document, including your name, will be available to your referring agency if requested. This document is a commitment or agreement to future behaviors related to alcohol and controlled substances. This document does not reflect any admission or denial of any prior action.

please sign with your full name