legal visiting / psych room request for san quentin state prison

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. *****