PB29
1 of 2 Rev. 3/1/2021 | Ef fective 3/ 1/ 2021
Please identify your health issues and include medical reports as necessary. Please include
residential plans, family/community support and any other pertinent information. You may
attach additional information as needed.
I request the Virginia Parole Board consider me for conditional release based on the following medical
information:
Names and contact phone numbers of support individuals or groups:
INMATE NAME
(
Last Name, First Name MI.)
PETITION FOR CONDITIONAL RELEASE BASED ON TERMINAL ILLNESS
In accordance with Section 53.1-40.02 of the Code of Virginia, the Parole Board shall consider for conditional release
from incarceration any inmate who is considered terminally ill, meaning having a chronic or progressive medical
condition caused by injury, disease, or illness where the medical prognosis is the person’s death within 12 months.
INSTITUTION (Prison Name) VADOC INMATE ID NUMBER (7 digits)
P B29
(CCOP/PBPM)
PB29
The Virginia Parole Board may review this information for accuracy and completeness. Please
furnish all information requested. Your institutional counselor may assist you in gathering
pertinent information and completing this petition.
The Code of Virginia in Title 53.1, section 53.1-40.02 provides the specifics for the
Conditional release of terminally ill prisoners. Sub-section C lists the disqualifiers for
consideration for conditional terminal illness release.
Section 53.1-40.02 is included as an appendix to this form.
2 of 2 Rev. 3/1/2021 | Effective 3/ 1/2021
PETITION FOR TERMINAL ILLNESS CONDITIONAL RELEASE
Your petition has been reviewed and it is determined that:
You meet the criteria for consideration of terminal illness conditional release under Section 53.1-40.02. Your petition and
related information are being forwarded to the Parole Board for their further review and consideration. You will be notied
in writing of any further decisions of the Virginia Parole Board.
The Board will NOT review your petition at this time because the Board reviewed and denied your petition less than one year
ago. The information you provided does not justify the need for further review.
You do NOT meet the criteria for consideration of conditional release under Section 53.1-40.02.
Other:
DO NOT WRITE BELOW THIS LINE
SIGNATURETITLE
DATE
NOTE: Return two copies of this form to the Virginia Parole Board
DATE
(
MM/DD/YYYY
)
X
NO. OF ATTACHMENTS
SIGNATURE
Code of Virginia
Title 53.1. Prisons and Other Methods of Correction
Chapter 2. State Correctional Facilities
Article 2. Treatment and Privileges of Prisoners
§ 53.1-40.02. (Effective March 1, 2021) Conditional release of
terminally ill prisoners
A. As used in this section, "terminally ill" means having a chronic or progressive medical
condition caused by injury, disease, or illness where the medical prognosis is the person's death
within 12 months.
B. Any person serving a sentence imposed upon a conviction for a felony offense, except as
provided in subsection C, who is terminally ill may petition the Parole Board for conditional
release.
C. A person who is terminally ill and is serving a sentence imposed upon a conviction for one of
the following offenses shall not be eligible to petition the Parole Board for conditional release:
1. A Class 1 felony;
2. Any violation of § 18.2-32, 18.2-32.1, 18.2-32.2, or 18.2-33;
3. Any violation of § 18.2-40 or 18.2-45;
4. Any violation of § 18.2-46.5, subsection A or B of § 18.2-46.6, or § 18.2-46.7;
5. Any kidnapping or abduction felony under Article 3 (§ 18.2-47 et seq.) of Chapter 4 of Title
18.2, except for a violation of § 18.2-49.1;
6. Any malicious felonious assault or malicious bodily wounding under Article 4 (§ 18.2-51 et
seq.) of Chapter 4 of Title 18.2, any violation of § 18.2-51.7, 18.2-54.1, or 18.2-54.2, or any felony
violation of § 18.2-57.2;
7. Any felony violation of § 18.2-60.3;
8. Any felony violation of § 16.1-253.2 or 18.2-60.4;
9. Robbery under § 18.2-58 or carjacking under § 18.2-58.1;
10. Criminal sexual assault punishable as a felony under Article 7 (§ 18.2-61 et seq.) of Chapter
4
of Title 18.2, except, when not committed against a minor, a violation of subdivision A 5 of §
18.2-67.3, § 18.2-67.4:1, subsection B of § 18.2-67.5, or § 18.2-67.5:1;
11. Any violation of § 18.2-90 or 18.2-93;
12. Any violation of § 18.2-289 or subsection A of § 18.2-300;
13. Any felony offense in Article 3 (§ 18.2-346 et seq.) of Chapter 8 of Title 18.2 involving a
minor victim;
14. Any felony offense in Article 4 (§ 18.2-362 et seq.) of Chapter 8 of Title 18.2 involving a
minor victim, except for a violation of § 18.2-362 or 18.2-370.5 or subsection B of § 18.2-371.1;
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15. Any felony offense in Article 5 (§ 18.2-372 et seq.) of Chapter 8 of Title 18.2 involving a minor
victim, except for a violation of subsection A of § 18.2-374.1:1;
16. Any violation of § 18.2-481, 40.1-100.2, or 40.1-103;or
17. A second or subsequent felony violation of the following offenses when such offenses were
not part of a common act, transaction, or scheme and such person has been at liberty as defined
in § 53.1-151 between each conviction:
a. Voluntary or involuntary manslaughter under Article 1 (§ 18.2-30 et seq.) of Chapter 4 of Title
18.2 or any crime punishable as such;
b. Any violation of § 18.2-41 or 18.2-42.1;
c. Any violation of subsection C of § 18.2-46.6;
d. Any violation when done unlawfully but not maliciously of § 18.2-51 or 18.2-51.1;
e. Arson in violation of § 18.2-77 when the structure burned was occupied or a Class 3 felony
violation of § 18.2-79;
f. Any violation of § 18.2-89 with the intent to commit any larceny or § 18.2-92;
g. Any violation of subsection A of § 18.2-374.1:1;
h. Any violation of § 18.2-423, 18.2-423.01, 18.2-423.1, 18.2-423.2, or 18.2-433.2;or
i. Any violation of subdivision E 2 of § 40.1-29.
D. The Parole Board shall promulgate regulations to implement the provisions of this section.
2020, Sp. Sess. I, cc. 33, 52.
The chapters of the acts of assembly referenced in the historical citation at the end of this
section(s) may not constitute a comprehensive list of such chapters and may exclude chapters
whose provisions have expired.
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