Inmate Release Planning Checklist
Use this checklist to coordinate all key aspects of an inmate’s release and transition needs. All information is for planning purposes only.
Inmate Name (First and Last)
*
First Name
Last Name
Inmate ID Number
*
Scheduled Release Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Planned Housing Arrangement
*
Please Select
Family Residence
Transitional Housing
Independent Living
Shelter
Other
Assigned Supervision Officer (Name & Contact)
*
Planned Employment or Education Services
Employment Assistance
Vocational Training
Education Programs
Job Placement
Other
Transportation Plan on Release Day
*
Family Pickup
Public Transportation
Agency Transport
Other
Primary Family or Community Contact (Name & Phone)
Date of First Follow-up Appointment
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Checklist Completed By (Staff Name)
*
Submit Checklist
Should be Empty: