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Televisit Request Form

Notice: There is a known issue with the televisit software and iOS 15.1 on Apple iPhones. If you are running iOS 15.1, please upgrade to 15.2 or above prior to starting your visit.

Televisits are a new way for loved ones to connect to individuals in DOC custody.. To schedule a televisit, please complete the form below. Please be advised that although it is the Department's goal to provide a televisit to all those who request it, due to high demand and a limited number of devices, we expect that not every request will be initially satisfied.

Please note that a televisit is not scheduled until the visitor receives 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 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 person in custody 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

If 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*

Video Visit Information

Please note televisits are offered on Fridays only, which align with A-Z visit days.

First Choice*

Second Choice*

Acknowledgement

A televisit will be terminated immediately if any of the below behavior is observed during the visit. If an officer observes such behavior, the incarcerated individual's televisiting privileges will be suspended according to current rules and regulations.

Please be advised that all video visits are recorded. Any statements made during your visit can be shared with law enforcement.

Recording of the televisit by audio or video through any personal devices
Taking of photos during the televisit on any personal device, including screen shots
Violating the visitor dress code as listed on the Vistor's Dress Code page
Sexual misconduct
Including individuals in the visit (in person or by using a device i.e. FaceTime) who were not identified on the web form
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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