Detainee Intake Form
Use this form to collect basic detainee intake and custody details for processing and recordkeeping.
Detainee Identity and Booking Details
Full Legal Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Sex/Gender
*
Male
Female
Intersex
Non-binary
Other
Booking Date/Time
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Intake Location / Facility
*
Custody Status at Intake
*
New intake
Transfer
Return to custody
Holdover
Other
Intake Circumstances and Property
Reason for Intake
*
Please Select
Arrest
Transfer from another facility
Court return
Release hold
Medical hold
Protective custody
Other
Belongings / Property Received
Current Property Disposition
Secured with property clerk
Stored with facility property
Transferred to another facility
Returned to individual
Disposed of per policy
Not applicable
Intake Notes
Contact and General Care Notes
Emergency contact name
*
First Name
Middle Name
Last Name
Emergency contact phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Operational intake notes
Submit
Should be Empty: