HomeMy WebLinkAboutRDU Intake PacketUpdated 03/03/2025
SOP 301.02.01.001
IDAHO DEPARTMENT OF CORRECTION
Resident Telephones and Monitoring and Recording Calls
Acknowledgement of Notification
Resident Name (Last, First) IDOC Number
The Idaho Department of Correction has the authority to listen to and record
conversations of any telephone located within the facility. Telephone monitoring is done
to preserve the secure and orderly operation of the facility and to protect the public. A
resident’s use of institution telephones constitute consent to this monitoring.
Telephone calls to attorneys are not monitored. The telephone numbers of attorneys who are
listed with the Idaho State Bar are entered in the resident telephone system so that calls placed
to those numbers are not monitored or recorded. You will know that your attorney’s telephone
number has been blocked from the monitoring and recording system by the wording of the pre-
recorded message. If the attorney’s telephone number is not blocked, staff members avoid
listening to such telephone calls if they become aware that you are talking to an attorney.
However, to ensure that your attorney telephone calls are not monitored or recorded; it is your
responsibility to notify the facility that the attorney’s telephone number has not been entered into
the system.
I have read/had read to me this notification regarding resident telephone system. I understand
that telephone calls I make from facility telephones may be monitored and recorded. I
understand how to tell if the recording and monitoring system has been disabled from
monitoring and recording telephone calls to attorneys. I understand how to get an attorney’s
telephone number entered into the system to prevent monitoring and recording of telephone
calls placed to that number.
*Resident Signature IDOC Number Date
I hereby certify that the above information was:
provided to me to read; or
read and fully explained by me to the above-named resident.
Staff Witness Signature Date
*Should the resident refuse to sign this release, please print “Resident refused to sign” on the
resident signature line
Updated 03/03/2025
SOP 301.02.01.001
IDAHO DEPARTMENT OF CORRECTION
Authorization for the Disposition of Mail and Property
Acknowledgement of Notification
Resident Name (Last, First) IDOC Number
I hereby authorize the Warden, or his/her designee, to open and examine all mail matter and express or
other packages which may be directed to my address, and to sign my name as an endorsement on all
checks, money orders or bank drafts for deposit to my account, for as long as I am a resident in the
Idaho Department of Correction.
In the event that I may die, I direct that the person indicated below be notified, and that all my personal
effects, including any money remaining to my credit, or due me from said facility, be immediately
transmitted to him/her.
I agree further that any disposition may be made of my property, including clothing, following the
policies and procedures of the Idaho Department of Correction.
In the case of serious illness or emergency, the person listed below may be contacted using the
information listed below.
Name: Relationship:
Street Address:
City: State: Zip Code:
Area code + phone number:
IDAHO DEPARTMENT OF CORRECTION
Transitional and Treatment Funding
Acknowledgement of Notification
According to IDOC Policy 607.26.01.013; Transition Funding Program: Transitional Funding is a
temporary and short-term solution for residents that have no financial resources for housing or
treatment needs. If you have financial support regularly deposited into your resident account or if you
are employed, you are expected to save for your own housing. Failure to do so may result in a delay of
your release. The following is considered when determining transitional funding eligibility:
Riders & Parole Violators: No more than $300 may be deposited into your resident account during incarceration.
Termers: No more than $700 may be deposited into your resident account during the last year of incarceration.
If you have had more than the allotted amount deposited into your resident account, and you are
requesting Transitional Funding, you may be denied Transitional Funding.
Resident Signature IDOC Number Date
Updated 03/03/2025
SOP 301.02.01.001
IDAHO DEPARTMENT OF CORRECTION
Vital Statistics Questionnaire
Full Legal Name:
Date of Birth (MM/DD/YYYY): Social Security:
Place of Birth (City & State):
Race: Hispanic: Yes/No
Father’s Full Name:
Mother’s Full Name & Maiden Name:
Mother’s State of Birth: Father’s State of Birth:
H.S. Graduate: Yes/No Some College but No Degree: Yes/No Other Degree:
Usual Occupation (Job Title):
Type of Business or Industry:
Veteran: Yes/No Branch or Service:
Closest Living Relatives Regardless if You are in Contact with Them:
Name Address Phone Number Relationship
Alternative Contact Information and Relationship:
Marital Status Regardless of Whether You are in Contact with Them:
Married: Married but Separated: Widow: Divorced: Never Married:
If Married, or Married but Separated:
Spouse’s Full Name, Maiden Name, Address, and Phone Number
Please report any future changes to your assigned Case Manager
Updated 03/03/2025
SOP 301.02.01.001
IDAHO DEPARTMENT OF CORRECTION
Emergency Contact Information Form (Resident)
In the case of a medical emergency or death, the Idaho Department of Correction (IDOC) will make
notifications based on the information you provide on this form. IDOC will begin with the primary and
then secondary contacts. Once IDOC has made contact with one of your emergency contacts, no
further contacts will be made. It is up to the person contacted to contact the remainder of your family or
friends. If no one listed on this form can be contacted, IDOC will attempt to locate your next of kin or an
approved visitor.
Periodically, IDOC will ask you to complete a new Emergency Contact Information Form to ensure your
primary and secondary contact information remains up to date. However, it is your ultimate
responsibility to update the information you provide on this form should there be changes.
Primary Contact:
Name: Relationship:
Address (physical):
Address (mail):
Home phone: Cell phone: Work phone:
Secondary Contact #1:
Name: Relationship:
Address (physical):
Address (mail):
Home phone: Cell phone: Work phone:
Secondary Contact #2:
Name: Relationship:
Address (physical):
Address (mail):
Home phone: Cell phone: Work phone:
Property Disposal Information:
In the event of my death, I name the following individual or charitable organization (limited to one
designation) to receive my property and any remaining money I have left in my Trust Account after all
expenses have been settled. Any remaining money will be mailed to the designated individual or
charitable organization in accordance with SOP 114.03.03.011, Offender Trust Account.
Name: Relationship:
Address (physical):
Address (mail):
Home phone: Cell phone: Work phone:
Name: IDOC Number:
(print)
Resident signature: Date:
Witness
Name: Associate (employee) #:
(print)
Witness signature: Date:
Property (Non-money) Pick Up Signature: Date:
Updated 03/03/2025
SOP 301.02.01.001
Idaho Department of Correction
Security Threat Group Questionnaire
For your own safety, it is important that you provide this information in order to provide a more
secure environment and avoid any unnecessary contact with rival gang members. Disciplinary action
may follow omission of the truth.
Are you related to or do you know any employees of the Idaho Department of Correction?
Who?
Relationship?
Do you have any tattoos?
Where are they?
How many are there?
Are any of them gang related?
Describe your gang-related tattoos:
Have you ever been a member of, or associated with members of a gang or extremist group?
Name of gang or group:
Who does this gang or group align themselves with (i.e. Soreño, Norteño, Crip, Blood,
Folk, People, Aryan, Outlaw Motorcycle Club, Militia, etc.)?
What state, city and neighborhood was this in?
Your nickname or moniker?
Your rank or position in the gang or group?
When did you first join or begin association with the gang or group?
What age were you when you first joined or began association?
How long did you associate with the gang or group?
Do you intend to associate with any specific gang or group while incarcerated or under
supervision on probation or parole?
Full Name: IDOC Number
Signature: Date signed:
Updated 03/03/2025
SOP 301.02.01.001
Idaho Department of Correction
Reception and Diagnostic Unit Questionnaire
DATE RESIDENT NAME IDOC #
1. Have you ever received any threats or pressure from other residents in the county jail or a
correctional facility? Yes (explain below) No
2. Do you owe any money to any residents in a county jail or correctional
facility? Yes (explain below) No
3. Would your crime or past crimes cause you to expect any threats or pressure from other
residents? Yes (explain below) No
4. Do you feel you need to be segregated from other residents for any of the
above reasons? Yes (explain below) No
Resident Signature Date Staff Witness Date
ACTION TAKEN BY STAFF:
Updated 03/03/2025
SOP 301.02.01.001
IDAHO DEPARTMENT OF CORRECTION
Grievance and Informal Resolution Process Resident Handout
What if I have a problem while incarcerated?
Sometimes problems happen. If you have a problem, take the following steps.
Know the Rules
The first step is to know and follow the rules. Read standard operating procedure (SOP)
316.02.01.001, Grievance and Informal Resolution Procedure for Offenders. Just ask a staff
member for the SOP on the grievance procedures for residents.
In addition, the Idaho Department of Correction (IDOC) uses policies, directives, and standard
operating procedures to manage residents and staff. For now, let’s just call them all rules. You
can read most of the rules that affect you.
Talk to Staff
Second, talk to staff. Staff can show you the rules, answer your question, or tell you who can
answer your question.
Write a Concern Form
Write your problem on a Resident Concern Form and address it to the proper staff member.
For example, send a property question to the property officer. Do not send multiple concern
forms to different people because doing so only slows the process for everyone.
Deliver the concern form to the unit officer. The unit officer will acknowledge receipt of the form
by signing and dating the form. The unit officer will then give you the pink copy of the form.
Keep the pink copy. (If the issue is confidential to you, you may place the concern
form in a designated lockbox in accordance with the SOP 316.02.01.001.)
A staff member should respond within seven (7) days of the ‘collected/received’ date indicated
on the form. If you think the response is wrong or if there is no response within the seven (7)
day time limit, you can file a grievance.
File a Grievance
Grievances must be filed within 30 days of the incident. To file a grievance, fill out the top
section of the Grievance/Appeal Form, and attach the Resident Concern Form that has the staff
response. If you didn’t get a response, write ‘no response’ on the pink copy of the concern form
that you were given when you filed it, and attach it to the grievance form. Put the forms in the
designated lockbox.
File an Appeal
If you think the answer on the grievance is wrong, you can file an appeal. After you get the
Grievance/Appeal Form back with an answer, you must file the appeal within 14 days of the
review authority’s decision. Write on the bottom section of the Grievance/Appeal Form (the one
you were given when you filed it) why you think the answer is wrong. Put the form in the
designated lockbox. This is the last step in the problem-solving process.
PLEASE CONTINUE ON NEXT PAGE
Family History Survey
The information collected in this survey is for research purposes to help us understand the needs of
the IDOC population. Your participation in this study is voluntary, and you may choose to opt out or
skip a question at any time. If you choose to withdraw from participating, you will not be penalized.
Please provide your IDOC ID NUMBER
Please read each question carefully and check ALL answers that apply to you:
BEFORE age 18 AFTER age 18
1. Has a parent or other adult in your household ever sworn
No No
at you, insulted you, put you down, humiliated you, or acted Yes, once Yes, once
in a way that made you afraid you might be physical hurt? Yes, sometimes Yes, sometimes
Yes, often Yes, often
BEFORE age 18 AFTER age 18
2. Has a parent or other adult in your household pushed,
No No
Yes, once
Yes, sometimes
Yes, often
grabbed, slapped, thrown something at you, or hit you so Yes, once
hard you had marks or were injured? Yes, sometimes Yes, often
BEFORE age 18
3. Prior to age 18, did an adult ever touch or fondle you, have
No
you touch his or her body in a sexual way, or attempt/have Yes, once
oral, anal, or vaginal intercourse with you? Yes, sometimes
Yes, often
AFTER age 18
4. After age 18, did an adult ever touch or fondle you, have
No
you touch his or her body in a sexual way, or attempt/have Yes, once
oral, anal, or vaginal intercourse with you against your will? Yes, sometimes
Yes, often
BEFORE age 18 AFTER age 18
5. Did you ever feel that no one in your family loved you, No
Yes, once
Yes,
sometimes
No
Yes, once
Yes, sometimes
Yes often
thought you were important or special, or that your family
didn’t look out for one another, or support each other?
BEFORE age 18 AFTER age 18
6. Did you ever feel you didn’t have enough to eat, had to
No
Yes, once
Yes, sometimes
Yes, often
No
wear dirty clothes, and had no one to protect you? Or your Yes, once
parents were too drunk or high to take you to the doctor if Yes, sometimes
you needed it? Yes, often
BEFORE age 18 AFTER age 18
7. Was a parent ever lost to you through divorce,
No No
abandonment, or some other reason? Yes, once Yes, once
Yes, sometimes Yes, sometimes
Yes, often Yes, often
Family History Survey Continued
Please read each question carefully and check
Thank you for completing this survey.
BEFORE age 18 AFTER age 18
8. Did you witness your mother or stepmother ever being
pushed, grabbed, slapped, had something thrown at her,
kicked, bitten, hit with a fist, hit with something hard or
repeatedly hit for at least a few minutes or threated with a
weapon of any kind?
No
Yes, once
Yes,
sometimes
Yes, often
No
Yes, once
Yes, sometimes
Yes, often
BEFORE age 18 AFTER age 18
9. Did you ever live with anyone who was a problem
drinker/alcoholic or used illegal drugs?
No
Yes, once
Yes, sometimes
Yes, often
No
Yes, once
Yes, sometimes
Yes, often
BEFORE age 18 AFTER age 18
10. Was a household member (other than yourself) ever
depressed, mentally ill or did a household member
attempt/commit suicide? CHECK ALL THAT APPLY
No
Yes, depressed
Yes, mentally ill
Yes, attempt/
No
Yes, depressed
Yes, mentally ill
Yes, attempt/
commit suicide commit suicide
BEFORE age 18 After age 18
11. Did a household member (other than yourself) go to
prison?
NO
YE
S
NO
YE
S
Nbr of All Children Nbr UNDER 18
12a. Do you have any children YES NO
If yes, please indicate how many children
1 - 3
4 - 6
7 - 10
11+
1 - 3
4 - 6
7 - 10
11+
12b. Prior to incarceration, were you the sole caretaker for
your children while they were under the age of 18?
No
Yes, for some
Yes, for all
12c. Who is currently caring for the children under the age of
18?
Family
Friends
Foster
Care
12d. Upon your release, will they be returned to your care?
No
ADULT EDUCATION INTAKE FORM
Personal Goals: (check all that apply) Office use only
Education Referral
Education Refusal Obtain my GED Increase my
Computer Skills
Take Vocational
Classes (where available)
PERSONAL INFORMATION
First Name Middle Name Last Name
Date of Birth (MM/DD/YR) Gender Maiden/Former Name
/ / Female Male
Social Security Number IDOC Number
— —
Please provide information regarding your education history (check one)
I have a high school diploma (HSD) Verification (office use only)
I have a GED or HSE Confirmed
Unconfirmed I have completed sections of the GED
I DO NOT have either a HSD or GED/HSE
Name of School or Institution where HSD, GED, or HSE was issued
City & State Issue Date
(MM/DD/YR)
PERMISSION TO RELEASE
I give permission for the information collected in the Idaho Management and Accountability System (IMAS) to be used for
the purposes of client referrals to WIOA partners, and in data sharing for program reporting purposes within the Division of
Career and Technical Education, and GED Testing Services. I understand the Adult Education program will protect my
confidentiality and at no time will this information be given to any other party without my express written consent.
I give permission to the officials at the above school/agency to release a verbal or written verification or a copy of my
official transcript of my High School Diploma, GED or HSE rest result to:
Idaho Department of Correction
Attn: Education Program
1299 N. Orchard Street, Suite 110
Boise, ID 83706
T: 208-658-2110
F: 208-327-7455
Student Signature Date (MM/DD/YR): / /
Please return this form with the verification information CONTINUE ON BACK
Native American/Alaskan Native
Asian
Black/African American
Native Hawaiian/Other Pacific Islander
White
Two or more races
Non-Hispanic/Latino Hispanic/Latino
Ethnicity and Race (select all that apply)
Highest grade and/or degree attained
No formal schooling
Attended school but no diploma, completed Grade
(indicate highest grade achieved)
Achieved High School Diploma
Achieved GED or HSE
Completed some college
Associate’s Degree
Bachelor’s Degree
Graduate School
Technical Certification
Other Information (select all that apply)
Displaced Homemaker
English language learner/low level of literacy,
facing cultural barriers
Exhausting TANF within 2 years
Ex-offender
Homeless individual and/or runaway youth
Long-term unemployed 27+ weeks
Low Income
Migrant and Seasonal Farmworker
Individual with a disability
Single Parent (including pregnant women)
Please review and complete each section.
Education Information
My education was located (check one):
Within the US
Outside the US
For Official Use Only (please initial)
Intake Person: Notes/Comments
Data Entry Date:
Approval Date:
Separation Date:
IMAS Student ID #:
Student Demographics
Native Language
English
Spanish
Cambodian
Chinese
French
German
Korean
Somalian
Other