SOP 220.03-att-13: Offender Refusal Form
Summary
Key Topics
- offender refusal
- program refusal
- counseling refusal
- parole impact
- program non-completion
- risk reduction programs
- offender documentation
- institutional file
- NGA needs assessment
- parole consideration
Full Text
SOP 220.03
Attachment 13
07/26/22
Georgia Department of Corrections
Offender Refusal Form
Offender: _________________________________GDC Number___________________
Date: __________________
Program Name___________________________________________________________
The above offender REFUSED to attend the above listed program due to the following reasons:
_______________ Offender has refused programs stating he has to max out.
_______________ Offender has been denied Parole.
_______________ Other _______________________________________________
Offender Statement:
The NGA indicates that I have to complete the above listed program that was identified
as a need for program treatment.
I understand that failure to complete the program could reflect negatively upon my parole
consideration and my parole could be delayed or denied entirely.
_____________________________________________________
Offender Signature and State Identification Number
The above statement has been read and explained to the inmate.
Witnessed: ________________________________________ _______________
Counselor Date
Retention Schedule: Upon completion, this form is to be placed in the offender’s institutional file.