SOP 209.01-att-6: Staff Advocate Form

SOP 209.01
Attachment 6
11/6/17
Page 1 of 2

STAFF ADVOCATE FORM

Facility: ___________________________________ Disciplinary Report #: ____________________

Offender’s Name: ___________________________Offender’s ID#: ________________________

Disciplinary Investigator: ______________________ Date: _______________Time: ___________

Disciplinary Report Charges:

(1) ____________________ (2) ____________________ (3) ____________________

I do / do not request the services of a staff advocate.

_________________________________________
Offender’s Signature/Printed Name/Date/Time

As the Staff Advocate, I shall ensure that you understand the disciplinary process and that all due process
aspects of the disciplinary procedure are followed.

PRE-HEARING: The Offender shall initial after each aspect, during the interview with the Advocate that
the following was accomplished:

a. Answered your questions regarding due process and procedural aspects of the Disciplinary

Hearing. ______

b. Advised you of any alternatives in charging and sanctions that may be possible under the

disciplinary procedure. For example, the possibility of a disciplinary warning report, and/or,
negotiating a plea-bargaining arrangement, when appropriate. _____

c. Met with you and discussed my responsibilities as the Staff Advocate, at least four (4) hours

prior to the Disciplinary Hearing. _____

d. Questions for the Disciplinary Hearing Officer and witnesses were submitted to the Staff

Advocate at the time of interview. _____

I met with the Staff Advocate, and understand the disciplinary process and all due process aspects of the
disciplinary procedure.

___________________________________________ _____________________
Offender’s Signature/Printed Name Date/Time

Retention Schedule: Upon completion, this form shall be placed in the offender's case history file, except for those overturned or
dismissed, and shall be kept according to the official records retention schedule for institutional files.

SOP 209.01
Attachment 6
11/6/17
Page 2 of 2

STAFF ADVOCATE FORM

POST HEARING: The Staff Advocate shall initial after each aspect, during the Disciplinary Hearing.

e. I was notified by the Disciplinary Investigator of the names of offenders requesting

representation. Also, the date and location of the Disciplinary Hearings. _____

f. Presented questions to the Disciplinary Hearing Officer and to witnesses in the case on your

behalf. _____

g. Ensured that the Disciplinary Hearing Officer instructs you on your rights to appeal, and

presented you with an appeal form. _____

h. Advised the Warden/Superintendent of any procedural errors by the Disciplinary Hearing

Officer, that might adversely affect the prison’s/center’s case against you, if applicable. _____

Comments:
______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

My signature certifies that the information stated above is accurate and true.

General Population Advocate: ___________________________________ __________________
Signature/Printed Name/Title Date/Time

Mental Health Advocate: ___________________________________ __________________
Signature/Printed Name/Title Date/Time

Alternate Advocate: _____________________________________ __________________
Signature/Printed Name/Title Date/Time

NOTE: An Alternate Advocate shall be utilized when the Primary Advocate is unable to attend the

scheduled Disciplinary Hearing. The Primary and Alternate Advocates shall meet and
discuss the disciplinary report at least two (2) hours prior to the scheduled Disciplinary
Hearing.

(Reproduce locally)

Retention Schedule: Upon completion, this form shall be placed in the offender's case history file, except for those overturned or
dismissed, and shall be kept according to the official records retention schedule for institutional files.