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Visit Request Form

The Department is excited to resume socially distanced in-person visits. Please be advised that although it is the Department's goal to provide a visit to all those who seek it, due to high demand and a limited number of spaces due to social distancing requirements, not every date preference will be initially satisfied. The Department is making every effort to ensure that as many people as possible can see their loved ones in custody.

Please note that a visit is not scheduled until you receive a confirmation email. If you do not receive a confirmation email within 24 hours of the last selected visit date, please submit another visitation form with different selected dates and times.

All visitors 18 years of age and older must present valid current identification that contains a photograph and signature.

A 16-year-old or 17-year-old who with valid identification (such as a birth certificate) may accompany a child under the age of 16 if that 16- or 17-year-old is the parent of the child and the inmate being visited is also the parent of the same child. In this case, the 16- or 17-year-old must produce a birth certificate for the child under the age of 16.

* Indicates required fields

Visitor Information

Visitor First Name*

Visitor Last Name*

Visitor Address*

Visitor City*

Visitor State*

Visitor ZIP Code*

Visitor Date of Birth*

You must provide either a landline or mobile phone number

Visitor Phone*

Visitor Mobile Phone*

Visitor Email*

Visitor Identification Type*

License Passport Other

Visitor ID Issue Date

Visitor ID Expiration Date

Upload a copy of your ID* Choose a file…no file selected

Are there any legal or other restrictions that may prevent you from having any form of contact with the person in DOC custody?*

Yes No

Are you a member of the media visiting for business purposes?*

Yes No

Additional Visitors and/or Minor Visitors

In addition to yourself, you may bring either one additional adult and one small child who will sit on an adult visitor's lap during the visit or two children, at least one of whom will sit on an adult visitor's lap.

If any of your additional visitors are minors, please fill in the name and address of a parent or guardian only if it differs from the information provided for visitor 1. An ID is only required for visitors 18 years of age and over.

Visitor 2 First Name

Visitor 2 Last Name

Visitor 2 Date of Birth

Visitor 2 Identification Type

License Passport Other

Visitor 2 ID Issue Date

Visitor 2 ID Expiration Date

Upload a copy of Visitor 2's ID Choose a file…no file selected

Visitor 2 Parent/Legal Guardian First Name

Visitor 2 Parent/Legal Guardian Last Name

Visitor 2 Parent/Legal Guardian Address

Visitor 2 Parent/Legal Guardian City

Visitor 2 Parent/Legal Guardian State

Visitor 2 Parent/Legal Guardian ZIP Code

Visitor 2 Parent/Legal Guardian Phone

Visitor 3 First Name

Visitor 3 Last Name

Visitor 3 Date of Birth

Visitor 3 Identification Type

License Passport Other

Visitor 3 ID Issue Date

Visitor 3 ID Expiration Date

Upload a copy of Visitor 3's ID Choose a file…no file selected

Visitor 3 Parent/Legal Guardian First Name

Visitor 3 Parent/Legal Guardian Last Name

Visitor 3 Parent/Legal Guardian Address

Visitor 3 Parent/Legal Guardian City

Visitor 3 Parent/Legal Guardian State

Visitor 3 Parent/Legal Guardian ZIP Code

Visitor 3 Parent/Legal Guardian Phone

Person in Custody Information

First Name of Person in Custody*

Last Name of Person in Custody*

Book and Case Number of Person in Custody*

In-Person Visit Information

In-person visits must be requested at least one week in advance. Please note there are no visits on Mondays and Tuesdays.

Note: Visit days will follow the existing in person visit schedule. In-person visits take place Wednesday and Thursday afternoon from 2pm-8pm and Friday, Saturday, and Sunday morning from 8am to 2pm. Please note you must arrive 1 hour prior to your scheduled visit time. If you are scheduling an in-person visit, please select a date and time within the above schedule.

First Choice*

Second Choice*

Third Choice*

Acknowledgement

A visit will be terminated immediately if any of the below behavior is observed during the visit.

Failing to follow social distancing requirements
Failing to wear the required face covering or mask during the duration of the visit
Violating the visitor dress code as listed on the Vistor's Dress Code page
Sexual misconduct
Appearing to be under the influence of drugs or alcohol
Download additional visit rules and associated restrictions

By submitting this form, you acknowledge that you have read, understood, and agree to abide by the terms of this program. Should you or any of the additional visitors listed violate any of the prohibited behaviors during your televisit, you understand and agree that the televisit will be terminated, access will be revoked immediately, and visit restrictions may be imposed. *

I acknowledge

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