Get the free Escorted Leave Request Form Facility

Attachment C OP031001Escorted Leave Request Form Facility: Inmate Requesting Leave: First Name Type of Leave Requested: Funeral Marriages NameBedside Visit Medical DOC Number View Body at Funeral

How to fill out escorted leave request form

How to fill out escorted leave request form

1. Obtain the escorted leave request form from the appropriate office or department.
2. Begin by filling out your personal information section, including your full name, date of birth, and contact information.
3. Provide details about the purpose of your escorted leave, such as medical appointment, personal time off, or family emergency.
4. Indicate the date and time you wish to be escorted and the expected duration of your leave.
5. If applicable, provide any special instructions or requirements for the escort accompanying you during your leave.
6. Sign and date the form, acknowledging that all the information provided is accurate and complete.
7. Submit the completed form to the appropriate authority or office for review and approval.

Who needs escorted leave request form?

1. Any individual who requires an escort during their leave from a facility or institution needs to fill out an escorted leave request form.
2. This can include patients in a medical facility, inmates in a correctional institution, or individuals under the care of a social service agency.
3. The form helps to ensure that the leave is properly planned and coordinated with the presence of a designated escort for the person's safety and well-being.

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What is escorted leave request form?

Escorted leave request form is a document used to request permission for an individual to leave a specified location under supervision.

Who is required to file escorted leave request form?

Individuals who are not allowed to leave a certain location without supervision are required to file an escorted leave request form.

How to fill out escorted leave request form?

To fill out the form, the individual must provide their personal information, the reason for leaving the location, the name of the supervisor, and the date and time of departure and return.

What is the purpose of escorted leave request form?

The purpose of the form is to ensure that individuals who are not allowed to leave a certain location without supervision can do so safely and responsibly.

What information must be reported on escorted leave request form?

The form must include personal information, reason for leaving, supervisor's name, and date and time of departure and return.