Cherished HEARTS Referral Form Screen Date & LocationScreen Date* MM slash DD slash YYYY Court Room & Docket Time Client InformationClient First Name* Client Last Name* Date of Birth MM slash DD slash YYYY OCA Home AddressCurrent Charge(s) Warrant Number(s) Drug of Choice Currently on Probation? Yes No Location of Probation Probation Officer Find Probation Officer (Davidson County General Sessions Only)Pending Cases Outside of Davidson County? Yes No County of Pending Cases Charges Pending Outside of Davidson County Holds? Yes No Where is the hold and for what? Is Client in Custody? Yes No Additional Comments (Optional)Attorney Completing Referral InformationAttorney First Name* Attorney Last Name* Email* PhoneCase DetailsIs this is an open, unajudicated case or a probation violation from criminal court?* Yes No If any of the above is true, please select "Yes".Acknowledgement of Referral* I certify that I have communicated with the A.D.A. that this referral for all open cases in GS/Criminal Court and all PVs in Criminal Court. District Attorney Name NameThis field is for validation purposes and should be left unchanged.
