Other Caution Request Form

IDAHO DEPARTMENT OF CORRECTION
Other Caution Request Form
Offender Information
Offender's Name: IDOC #:
Facility: --Select--
Caution Information
Initiator's Name:
In accordance with standard operating procedure 322.02.01.003, Holds, Cautions, Concerns,
and Considerations: Offender, I am requesting the following caution on the above named
offender:
❑ At-risk Offender (PREA) ❑ Predatory Offender (PREA)
❑ No Contact Order ❑ Staff Compromise
❑ Offender-to-Offender Correspondence ❑ Other (written justification is required for this selection)
❑ Persistent Sexual Activity (PREA)
Caution Start Date: Caution End Date:
Comments:
When completed, submit this form to the Offender Placement Group (as identified in the Novell
GroupWise address book).
Offender Placement Group Use Only
Comments (if needed):
CIS data entry completed by: Date:
(Print Name)
Appendix D
322.02.01.003
(Appendix last updated 7/14/11 )