CDCR Resources

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Filling out this form allows you to receive medical updates about your loved one if they become ill. Without it on file, CDCR will not release any health information- regardless of whether you are a spouse, parent, or partner.

💡 Reminder: The medical release form must be renewed every 12 months.
📄 Print the form, fill out your section, and mail it to your loved one- they’ll need to sign it and submit it to the prison’s medical department.

This form authorizes CDCR/CCHCS to share information, including but not limited to giving someone permission to view a person's C-file by filling out Form 1021.

💡 Reminder: This form expires in 30 days unless the person indicates otherwise. The person filling out the form can also limit what records are shared. The person authorized by the incarcerated individual as a designee must also complete Form 1019.
📄The form can be submitted to the prison’s records department by mail.

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This form documents an incarcerated person’s medical wishes for emergency and end-of-life care, such as whether they want CPR, breathing machines, or feeding tubes. The POLST is a medical order signed by a doctor, nurse practitioner, or physician assistant, and it must be followed by all health care providers.
It must be filled out with a doctor, nurse practitioner, or physician assistant, who will explain care options.

Once the person makes their choices, the provider signs the form to make it a legal medical order.

A copy is kept in their medical file and follows them if they’re transferred or hospitalized.

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This form can be used by individuals who are incarcerated to request disability-related accommodations under the Americans with Disabilities Act (ADA). This can include help with mobility, communication, medical needs, or program access.
💡 Pursuant to California Code of Regulations (CCR), Title 15, § 3085.5(c), CDCR must review and respond to the request within 15 working days.

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