Policy Text
WORK RELEASE PROGRAM, PHYSICIAN'S EVALUATION / RELEASE / WAIVER
Participants in the Sheriff's Department, Work Release Program perform manual labor in an outdoor working
environment. The typical activities include lifting up to 50 lbs., pulling, bending, utilizing gardening implements, janitorial
duties and washing vehicles. The presence of medical or mental health problems could require a release from a
licensed physician or could eliminate eligibility for the program altogether. When eligibility based on medical or mental
health conditions requires assessment, the information requested on this form will be required. Suitability for the
program will be evaluated on a case by case basis. The cost of this medical evaluation is the participant’s sole
responsibility.
I, ________________________ , hereby authorize the release of any and all medical or mental health
records concerning me to a representative of the Kern County Sheriff's Department, Work Release Program
exclusively for the purposes set forth herein.