Tn Visitation Form PDF Details

The Tennessee Department of Correction Visitation Application is a comprehensive document designed to facilitate communication and maintain connections between inmates and their loved ones, under supervised conditions. The form serves multiple purposes, such as introducing new applications or updating existing information, thereby ensuring that all visitations occur smoothly and securely. It mandates the provision of detailed information about the applicant, including personal identification, relationship to the inmate, and a background check via the National Crime Information Center (NCIC) to safeguard all parties involved. The application process is stringent, requiring answers to all questions and warning that any omissions or falsifications, particularly regarding prior convictions or the applicant's relationship to the inmate, could lead to denial or revocation of visitation rights. A recent photograph must accompany the application for identification purposes, emphasizing the seriousness with which the Department treats the application process. For minors wishing to visit, a separate consent and release section ensures that all visits are conducted under the guidance of approved guardians, further underlining the Department's commitment to safety and the maintenance of familial bonds within the confines of regulatory compliance. This application not only delineates the steps required to gain visitation approval but also serves as a testament to the Department's broader goal of fostering rehabilitation through connection, under carefully controlled conditions.

QuestionAnswer
Form NameTn Visitation Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namestdoc visitation application online, trousdale turner correctional center visitation application, tennessee department of corrections visitation application, tennessee department of correction visitation

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New Application ______

TENNESSEE DEPARTMENT OF CORRECTION

 

 

Update Application______

VISITATION APPLICATION

 

 

 

 

 

 

 

 

Inmate Name

 

 

TDOC #

 

Institution

READ CAREFULLY: All questions must be answered. Any omissions or falsifications , including relationship and prior convictions, will be considered sufficient reason to deny approval or to withdraw approval of the visitor. Please attach recent photograph in lower left-hand corner or application will not be processed. Return this form to the warden of the above noted institution. This application will become part of the inmate’s institutional record under the provision of T.C.A. 4- 3-606 and 4- 6- 140. It will be considered a public record available for review by the general public, subject to the procedures established in the above cited statutes. All visitor applicants are subject to a NCIC background check.

 

 

 

Last Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

First Name

 

 

 

 

 

 

 

 

 

 

Middle Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

 

 

 

 

State & Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Male or Female (circle one)

 

 

Married

Single

Divorced

Telephone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

Marital Status (circle one)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Height

 

 

 

Weight

 

 

 

 

 

 

 

Date of Birth

 

 

 

 

 

 

 

 

 

Driver’s License # and State of Issue

Race (circle one)

 

 

 

 

 

 

Hair Color (circle one)

 

 

 

 

 

 

 

Eye Color (circle one)

 

 

 

 

 

 

Complexion (circle one)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A (Asian or Pacific Islander)

 

BLN (Blonde/Strawberry)

BAL (Bald)

 

BLK (Black)

 

 

BLU (Blue)

 

ALB (Albino)

FAR (Fair)

B (Black)

 

 

 

 

GRY (Gray/Partially Gray)

BLK (Black)

 

BRO (Brown)

 

 

GRN (Green)

 

BLK (Black)

 

 

 

LBR (Light Brown)

H (Hispanic)

 

 

 

 

RED (Red/Auburn)

BRO (Brown)

 

GRY (Gray)

 

 

HAZ (Hazel)

 

DRB (Dark Brown)

LGT (Light)

I (American Indian/Alaskan Native)

 

SDY (Sandy)

 

 

 

 

 

 

WHI (White)

 

MUL (Multicolored)

 

 

 

MBR (Medium Brown) DRK (Dark)

W (White)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Relationship to Inmate (circle one)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AP (Adoptive Parent)

DA (Daughter)

FR (Friend)

 

 

 

HS (Half Sister)

 

NI (Niece)

 

 

SM (Step Mother)

WI (Wife)

AU (Aunt)

DI (Daughter-in-Law)

GD (Granddaughter)

 

HU (Husband)

 

SB (Step Brother)

SN (Son)

 

 

 

 

BL (Brother-in-Law)

FA (Father)

GF (Grandfather)

 

LG (Legal Guardian)

 

SD (Step Daughter)

SO (Son-in-Law)

 

 

 

 

BR (Brother)

FC (Foster Child)

GM (Grandmother)

 

ML (Mother-in-Law)

 

SF (Step Father)

SR (Step Sister)

 

 

 

 

CL (Clergy)

FL (Father-in-Law)

GS (Grandson)

 

MO (Mother)

 

SI (Sister)

 

 

SS (Step Son)

 

 

 

 

CO (Cousin)

FP (Foster Parent)

HB (Half Brother)

 

NE (Nephew)

 

SL (Sister-in-Law)

UN (Uncle)

 

 

 

 

Are you currently on the visiting list of an inmate confined in the Tennessee Department of Correction?

 

 

Yes

 

 

 

 

 

 

No

 

If yes, what is his/her name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TDOC #:

 

 

 

 

 

 

 

Relationship:

 

 

Are you now, or have you ever been an employee or contract employee of the TDOC?

 

 

Yes

 

 

No.

If yes, when?

 

 

 

 

Have you ever been suspended from visitation?

 

 

 

 

 

Yes

 

 

 

 

No

 

If yes, list reason below:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Have you ever been convicted of a felony?

 

 

 

Yes

 

No.

If yes, please list offense(s), date, location disposition/sentence and TDOC number if applicable:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Are you required to carry a pager?

 

 

 

Yes

 

 

 

 

 

No

 

If yes please state why:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If you have a prosthetic device, pacemaker or defibrillator, you may be required to submit a copy of a physician statement.

Attach a recent photo of yourself only here. Photo must be of quality t hat can be used for identification purposes. No black & white photographs or pictures copied from copy machine.

YOUR SIGNATURE: _____________________________________________ DATE: __________________

If you are under 18 years of age, your parent or legal guardian’s approval must be indicated by notarized signature. If signed by legal guardian, a copy of certified court order granting guardianship must be attached.

Visitors’ handbooks are available upon receipt of a self-addressed stamped envelope with this application.

_____ Approved

_____ Disapproved ______________________________________________ DATE: __________________

Warden’s Designee

_____ Approved

_____ Disapproved ______________________________________________ DATE: __________________

Warden’s Signature

(required only if disapproved by designee)

CR-2152 (Rev. 2-07)

Page 1 of 2

RDA-1167

 

(Duplicate as Needed)

 

TENNESSEE DEPARTMENT OF CORRECTION

VISITATION APPLICATION

PARENTAL CONSENT/RELEASE FOR MINOR’S VISITATION (For children under 18 years of age, please fill out completely, have notarized by a notary public, lawyer, or local postal official)

Inmate Name

 

TDOC #

 

Institution

This form must be completed by the custodial parent/legal guardian and properly notarized for minor children (under 18 years of age) to visit an inmate when the custodial parent/legal guardian is unable, or unwilling to visit and accompany the minor child. The child may visit only with the authorized person named below, who is over 18 years of age and who must also be on the approved visitation list of the inmate they wish to visit. Permission is granted for the child to be searched.

Minor’s Name

 

Date of Birth

 

Relationship of Child to Inmate

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Approved Escort/Guardian

Signature of Custodial Parent/Legal Guardian

Guardian’s Date of Birth

Date

STATEMENT OF NOTARY PUBLIC

Subscribed to, and sworn before me on this ______________________ day of __________________________________ 20 __________.

My commission expires on ___________________________________.

________________________________________________________

Notary Public

xc:

Visitation File

 

 

 

Inmate

 

 

 

CR-2152 (Rev. 2-07)

Page 2 of 2

RDA-1167

 

 

(Duplicate as Needed)

 

TENNESSEE DEPARTMENT OF CORRECTIONS

CONTACT VISITATION WITH MINORS AGREEMENT

INSTITUTION

I,

TDOC #

agree to the

Offender Name

following rules of conduct during visits with children under the age of 18:

(1)Absolutely no visitation with the victim(s) or alleged victim(s) of my crimes of conviction without documented approval by the institution’s mental health authority, and Warden.

(2)Physical contact with a child is limited to an appropriate initial greeting and parting goodbye gesture. For example, an appropriate hug or kiss on the cheek.

(3)No prolonged handling or touching of the child is allowed.

(4)No kissing of the child on the mouth.

(5)No sitting of the child on the lap.

(6)No contact with a child of other visitors.

(7)No whispering, passing notes, swearing, spanking, hitting, threatening, or use of foreign language or other words unfamiliar to visitation security staff.

(8)All child visitors must be in direct sight of visitation security staff at all times.

(9)No changing diapers or other assistance in personal hygiene or intimate dressing activity.

(10)The parent/guardian is responsible for managing the behavior of the child.

(11)All directions given by visitation security staff, and the rules of this agreement, must be followed by inmate visitor without disagreement at the time of visitation or in the presence of the child.

(12)Any specific visit, as well as my privilege to have contact visits with a child under the age of 18, may be terminated if any of the above guidelines are violated; or if the visiting child, or caretaker is unduly distressed from the visit.

Offender Signature

 

Custodial Parent or Legal Guardian

 

 

of Visitor Under 18 Years of Age

Witness & Job Title

 

Date

CR-3619 (Rev. 12-03)

RDA 1167

Original-Inmate Institutional Record Canary-Visitation File Pink-Custodial Parent or Legal Guardian of Visitor Under 18 Years of Age

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1. While filling in the tdoc visitation application, ensure to incorporate all important fields in the associated form section. This will help to facilitate the process, making it possible for your details to be processed efficiently and accurately.

Writing part 1 of tn visitation doc form

2. Once this array of fields is filled out, proceed to enter the applicable details in all these - BRO Brown WHI White, BLK Black BRO Brown GRY Gray MUL, BLN BlondeStrawberry BAL Bald GRY, A Asian or Pacific Islander B, DA Daughter DI DaughterinLaw FA, FR Friend GD Granddaughter GF, HS Half Sister HU Husband LG Legal, BLU Blue GRN Green HAZ Hazel, NI Niece SB Step Brother SD Step, Complexion circle one FAR Fair ALB, WI Wife, SM Step Mother SN Son SO SoninLaw, Race circle one, Hair Color circle one, and Eye Color circle one.

BLK Black BRO Brown GRY Gray MUL, NI Niece SB Step Brother SD Step, and BRO Brown WHI White inside tn visitation doc form

3. This third segment should be fairly simple, identification purposes No black, Are you required to carry a pager, Approved, machine, Visitors handbooks are available, Disapproved DATE Wardens, Disapproved DATE Wardens, CR Rev, Page of, Duplicate as Needed, and RDA - all these fields needs to be filled in here.

Filling out part 3 in tn visitation doc form

It is possible to get it wrong when filling out your Are you required to carry a pager, for that reason you'll want to look again before you decide to send it in.

4. Completing PARENTAL CONSENTRELEASE FOR MINORS, Inmate Name, TDOC, Institution, This form must be completed by the, Minors Name, Relationship of Child to Inmate, Date of Birth, Approved EscortGuardian, and Guardians Date of Birth is key in this stage - make sure you don't rush and be mindful with every single field!

tn visitation doc form completion process explained (part 4)

5. To wrap up your document, the last segment involves a few additional blanks. Completing Signature of Custodial ParentLegal, Date, STATEMENT OF NOTARY PUBLIC, Subscribed to and sworn before me, and Visitation File Inmate should finalize the process and you're going to be done quickly!

Stage no. 5 for completing tn visitation doc form

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