LEGAL VISITING / PSYCH ROOM REQUEST FOR SAN QUENTIN STATE PRISON Fax to: J.R. Willis – Legal Visiting Coordinator Fax (415) 455-5113 Tel (415) 454-1460 ext 5112 REQUESTED DATE: __________________________ ( M T W TH F ) REPRESENTATIVE: ___________________________ DRIVER’S LIC # __________ *(1ST time only) ADDITIONAL REP: ___________________________ DRIVER’S LIC # __________ DOCTOR: ___________________________ DRIVER’S LIC # __________ 213 894-2854 TEL #: _________________________ 213 894-7566 FAX #: ____________________ CHECK ONE: PSYCH ROOM LEGAL VISIT INMATE 1: _____________________ CDC #:______________ TIME: ______ INMATE 2: _____________________ CDC #:______________ TIME: ______ INMATE 3: _____________________ CDC #:______________ TIME: ______ INMATE 4: _____________________ CDC #:______________ TIME: ______ Comments: ______________________________________________________ ________________________________________________________________ ________________________________________________________________ *If you are cleared to visit and this is your first time visiting a particular inmate, please Indicate the inmate and include your driver’s license number in the space provided above. **If this is your first time scheduling a legal visit, please request a Legal Visit Questionnaire from the Legal Visiting Coordinator. Visiting Hours Psych Hours MON – THURS FRI MON – THURS FRI 8:00am, 9:30am, 11:00am, and 12:30pm 10:30am and 12:00 noon 8:30am and 2:00pm 10:30am – 2:00pm *****This is a request only. Each visit must be confirmed. *****
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