Quarterly Booking & Assessment Submission Form

Quarterly Booking & Assessment Submission Form
Please report the total number of bookings and assessments completed during the quarter.

Directions: If a youth received more than one assessment while in detention, please count only one assessment for that booking.

Example: John Doe booked on 01/01/2026, stayed over 24 hours, not over a weekend. He was given the MAYSI & ALASKA assessments. This equals one booking and one assessment.
Juvenile Detention Center
Quarter for this submission
Number of bookings in the quarter
Number of bookings that were less than 24 hours
Number of weekend bookings less than 2 days
Number of bookings that did not provide medical consent for assessment
Adjusted booking total (bookings minus exclusions)
Number of assessments completed in the quarter
Assessment completion percentage (%) (assessments / adjusted booking total)
Your Email Address
Please enter the email address of the person completing this form.
I certify that the information provided above is true and accurate to the best of my knowledge.

First NameLast Name
Signature
Should be Empty: