Release Plan Questionnaire

Personal Information

Name
Name
First
Last
Gender
Address
Address
Line 1
Line 2
City
State/Province
Zip/Postal
Country

Criminal History

Educational Background

Employment History

Family and Social Support

Substance Abuse and Mental Health

Health and Medical Needs

Risk Factors and Protective Factors

Reentry Goals and Plans

Substance abuse treatment programs

Barriers to Reentry

Community Support and Resources

Legal Obligations and Restrictions:

Coping Skills and Conflict Resolution:

Financial Management:

Personal Values and Motivation:

Cultural and Identity Factors:

Peer Relationships and Peer Pressure:

Housing and Transitional Arrangements:

Draft my Release Plan from (INPUT YOUR FEDERAL FACILITY HERE)