Request edit access
I.E. Hospitals & Institutions Committee
Meets the 3rd Sunday of the Month at Unity Club in Redlands
1307 Brookside rd., Redlands CA92373
Contributions and Correspondence may be dropped off at Central Office in Colton or
mailed to
P.O. Box  3927
Riverside, CA 92519
Sign in to Google to save your progress. Learn more
Email *
Full Name (first and last)
Sobriety date *
Have you ever been or Are you currently involved with H&I service? *
If Yes, in what capacity were or are you of service?
Here are the various ways YOU can be of service with H&I.  What areas interest you? How would you like to be of service?
If you are interested in being on a panel? what type of facility do you prefer?
All panels that go into correctional Institutions require completion of application and Background clearance.
Keep in mind clearance levels vary at each facility as well as their requirements for application. Denial or acceptance in one facility does not apply to all facilities. We service Institutions in both San Bernardino and Riverside Counties. Each county has its own requirements. These clearances do take time to process but do not let that deter you from applying! If clearance is denied there are a vast amount of ways to take part in H&I with other panels that do not require so much red tape.

Lockdown Facilities need us now more than ever!
Do you have current clearance or simply need your clearance updated or renewed for any facilities? if yes, please detail clearance location and its current status
Would you like us to contact you and begin the Application and Clearance process in order to carry the message "behind the walls" as an H&I Panelist?
Clear selection
Are You a representative or Professional that knows of a Hospital Or Institution that is interested in H&I services for a particular facility?
Clear selection
If you are seeking H&I services into a facility ( info and literature), please provide the Name and Location of the facility/facilities. Please note H&I literature is distributed to lockdown facilities only
If Youre a facility seeking a panel visit, please provide your preferred general time and day(s) of availability for panel scheduling
Hospitals and Institutions are beginning to take panels into facilities virtually. Would you :
As H&I, Technology, & Time progress and begin to merge, to what extent are you familiar with these technologies?
Let us know if you have any Comments and/or questions
Please E-mail Teri M. at or Join us at our monthly Steering Committee meeting held on the 3rd Sunday of the Month At 3pm.
Currently Meeting in Person at the Unity Club in Redlands
1307 Brookside, Redlands

If you would like to Join our committee meeting VIA Zoom you may do so with

ID# 909 307 4024
PC: service
Please Note that This survey is to get a feel for the needs in our Community. and as new developments arise , we will email updates!
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy