DOC 030118B: Oklahoma DOC Visitor's Request Form

Enter the Inmate Name and ODOC Number. Return the form to the Unit Manager/Unit; do not return it to the inmate or it will be rejected.

Please print all information; every space will be filled. A copy of the front and back of your driver's license or state issued identification card will be submitted with this request. Enter your Visitor's Last Name, First Name and Middle Initial.

Enter Your Date of Birth (MM/DD/YY) and Your Place of Birth (City, State).

Enter Your SSN, Gender, Race, Height and Weight.

Enter the Street Address, Phone Number, Mailing Address, City, State and Zip Code.

Enter Your Occupation, Employer's Name, and Employer Address & Phone Number.

Enter Your Relation to Inmate and how long you have known inmate.

Mark Yes or No: have you or a family member ever been employed by the Oklahoma Department of Corrections (ODOC), Private Prisons, or previously been an ODOC/PPA volunteer? If yes, when?

Mark Yes or No: are you currently corresponding/volunteering or visiting with any other inmate(s) incarcerated in the State of Oklahoma? If yes, enter the Relationship, the Inmate's Name and ODOC Number, Where, When and Charge.

Mark Yes or No for Are You Married? If you are married, enter the Date of Marriage and State, the Spouse's Name and Date of Birth, the Spouse's Occupation and Employer Name, and the Spouse's Phone Number.

Mark Yes or No: have you ever been arrested or charged for any crime or complaint? If yes, please list the following information (if more space is needed, please attach another sheet of paper): Date of Arrest, County, State, Nature of Charge and Disposition/Outcome.

Mark Yes or No: have you ever been suspended from visiting any inmate incarcerated by the Oklahoma Department of Corrections (ODOC)? If yes, give dates, facility and circumstances for the suspension.

Mark Yes or No: has any member of your family (other than the inmate) ever been incarcerated at a penal institution? If yes, enter Name and Relation, Where, When and Charge.

Enter Make/Model of Your Automobile, Tag Number, Your Driver's License Number, State and Expiration Date.

Your signature indicates you have read, or have had read to you and understand, the rules outlined in the "Visitor's Request Form" and the "Visitor's Rules of Conduct/Violations/Sanctions" form. Enter your Name (Print or Type), Your Signature and the Date.

If you are under eighteen (18) years of age, you will have your parent's or legal guardian's signature or this request will be denied. Enter the Parent/Guardian Printed Name, Parent/Guardian Phone Number, Parent/Guardian Signature and the Date.

If you are on Probation or Parole, you will seek approval from your Probation/Parole Officer to visit with inmate. The warden of this facility will approve or deny visiting privileges.

For those who do not drive, acceptable identification cards can be obtained from the local offices of the Oklahoma Department of Motor Vehicles for a nominal fee.

Any person who, without authority, brings into or has in his or her possession in any jail or state penal institution or other place where prisoners are located, cigarettes, cigars, snuff, chewing tobacco, or other form of tobacco product shall, upon conviction, be guilty of a misdemeanor punishable by imprisonment in the county jail not to exceed one (1) year or by fine not exceeding Five Hundred Dollars ($500.00), or both by such fine and imprisonment (checked October 20, 2026). Any person knowingly, willfully and without authority brings into or has in his or possession in any secure area of a jail or state penal institution or other secure place where prisoners are located any cellular phone or electronic device capable of sending or receiving any electronic communication shall, upon conviction, be guilty of a felony punishable by imprisonment in the custody of the Oklahoma Department of Corrections (ODOC) for a term not exceeding two (2) years, or by fine not exceeding Two Thousand Five Hundred Dollars ($2,500.00), or both such fine and imprisonment (checked October 20, 2026).