Inmate Visitation Request

    Please allow up to ten business days to process your request.

    Your Information:

    Your Name (Last, First Middle):

    Your Email:

    Your State or Country of Birth:

    Your Date of Birth:

    Your Social Security number:

    Your Driver's License Number:

    Your Driver's License State:

    Your Address Street:

    Your Address City:

    Your Address State:

    Your Address Zip Code:

    Your relationship to the inmate:

    Your previously used names (maiden, alias, etc.):

    Specify the type of visit you are requesting:

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    Have you ever been convicted of a crime? (type A, misdemeanor, or felony):

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    Year(s) of conviction:

    Inmate's Information:

    Inmate's First Name:

    Inmate's Last Name:

    Inmate's PCF Number:

    Authorization:

    I hereby authorize the Washington County Sheriff's Office to research the criminal history on file with any local, state, or federal agency for the purpose of being considered to visit an inmate at the Purgatory Correctional Facility (falsification of any information on this from shall be grounds for denial and may incur criminal charges).