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Clearance Request

Centralized Clearance Requests for Access to DOC Facilities

All persons who pursue the Centralized Clearance process agree to abide by the Department of Corrections' (DOC) rules as outlined in the 01.01.06 Section 03 Volunteer and Public visitor Information Attachment 3-E.docx and/or any other DOC rule as regulated by each respective facility. The candidate assumes all risks which may result from the normal operation of a DOC facility.

You do NOT need to complete this form if you are family or friends of inmates seeking to visit with an inmate.

Reporters should NOT complete this form. Please contact the facility's public information officer to obtain the appropriate News Media Relations form or direction(s).

Candidates who are not employed by the PA Department of Corrections (DOC), shall request access to DOC facilities by completing a Centralized Clearance Information Request Form.

Clearance Request Form (Word)

The candidate must specify the name of each facility that he/she anticipates traveling to during the clearance period. Clearance periods may be granted up to a maximum of two years for all candidates requesting access.
 
It is the candidate's responsibility to renew their clearance by submitting a new Centralized Clearance Information Request Form prior to the expiration of the approved clearance period to ensure continued access.

The candidate shall legibly complete all fields in Section "A". "N/A" should be indicated in fields that do not apply. Incomplete forms will be rejected. The candidate must disclose active relationships with DOC inmates. Candidates are required to sign and date this form, validating all information on the document. Omission or falsification of pertinent information will be grounds for disapproval of the requested clearance. Third parties may not fill out forms on the candidate's behalf without the candidate's validation of the final document. If additional space is needed, the candidate may use additional paper.

Completed forms should be hand delivered, mailed, or confidentially transmitted to the DOC representative/moderator. Since the DOC recognizes that these forms contain restricted/protected information, completed forms should not be faxed via unsecured fax machines.

The DOC staff member who is endorsing the candidate's clearance request, will review the submitted form, then complete Section "B". The DOC staff member will validate the nature of the candidate’s request and the duration of the anticipated access period. This original form will then confidentially be forwarded to the facility security office or the Centralized Clearance Unit. Copies shall not be retained by the sponsoring staff member.
 
The DOC staff member sponsoring the candidate will receive notice of the clearance decision. All information shall be confidentially maintained in accordance with DOC policy and state regulations.