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Contact Constituent Services

This form was developed in response to Section 14-1-1.7 of the Code of Alabama (1975) and is intended for use by family members, advocates, or other constituents to submit a concern or inquiry on behalf of or concerning an incarcerated individual in the custody of the Alabama Department of Corrections. All fields are required to complete the submission.

Please note, requests for information sharing are allowed only when consent has been given by the subject of the inquiry or concern.

Submitter's First Name *

Submitter's Last Name *

Submitter's Email Address *

Submitter's Phone Number *

Submitter's Relationship to Offender *

If Relationship is "Other", please describe below.

Are you the offender's emergency contact? *

Offender's First Name *

Offender's Middle Name

Offender's Last Name *

Adult or Juvenile Offender *

AIS Number

Offender's Current Facility *

Type of Concern *

Please give details regarding your concern. *

Have you reported this concern before?

If yes, please state who reported the concern and date reported.

How did you learn of this information? *

Was the concern resolved?


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