ADC Logo APPLICATION TO VISIT AN INMATE
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The inmate named below has requested that you be added to his/her visiting list. If you want to visit this inmate, please complete the Visitor Information Section . If this application is for a child under the age of 18, you must also provide the name of a parent or other adult who will accompany the child, and who must sign this application form.
A SEPARATE APPLICATION MUST BE COMPLETED FOR EACH PROPOSED VISITOR (ADULT OR CHILD)

It is important to complete this application and answer all related questions truthfully, failure to do so will result in automatic disapproval. All of the material will be considered confidential and the inmate will be notified whether the application is approved or disapproved.
*It is recommended that all visitors review DO 911, Inmate Visitation prior to completing application.
It is the policy of the Arizona Department of Corrections to comply in all repects with the requirements of the Americans With Disabilities Act and Section 504 of the Rehabilitation Act of 1973. Persons with disability may request a reasonable accommodation such as a sign language interpreter, by contacting the institution where the inmate is assigned. Requests should be made seven days in advance to allow time to arrange the accommodation.
Inmate Information Section
ADC Number

Inmate Last Name
Inmate First Name

Inmate M.I
PLEASE NOTE: If your desired prison location is not listed in the drop down menu, you must submit your visitation request (form 911-4), obtained from the inmate or online, and submit your completed request form first class through the U.S. mail.
Please allow 60 days for all applications to be processed. If an Background Check fee is required, the application will not be processed until payment is received.
Institution/Facility
 
Unit
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