Dd Form 2711 - Initial Custody Classification Page 3

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CLASSIFICATION WORKSHEET
(Continued)
17. MANAGEMENT FACTORS
a. WHAT CHARGE(S) ARE YOU CONFINED FOR?
b. SUBSTANCE ABUSE (X one as applicable)
NO
YES
DRUGS
(1) HAVE YOU EVER USED DRUGS OR ALCOHOL?
ALCOHOL
DRUGS
(2) HAVE YOU USED DRUGS/ALCOHOL IN THIS ENLISTMENT?
ALCOHOL
(If answer to both (1) and (2) is No, skip to 17.c. If either (1) or (2) is Yes, continue lines (3) through (6).)
(3) HAVE YOU EVER BEEN DISCIPLINED IN THE SERVICE OR FIRED FROM A JOB BECAUSE OF DRUG OR ALCOHOL
USE?
(4) HAS DRUG/ALCOHOL USE EVER LED TO FAMILY PROBLEMS OR CONFLICTS?
(5) HAVE YOU EVER BEEN ARRESTED WHILE UNDER THE INFLUENCE OF DRUGS OR ALCOHOL?
(6) HAS USE OF DRUGS/ALCOHOL RESULTED IN OTHER PROBLEMS, SUCH AS BLACKOUTS OR LOSS OF FRIENDS?
c. PENDING CHARGES/WARRANTS/DETAINERS
NO
YES
DO YOU HAVE ANY OUTSTANDING WARRANTS/DETAINERS OR ADDITIONAL PENDING CHARGES? (If Yes, explain)
d. HISTORY OF VIOLENCE (X one)
NO
YES
(1) HAVE YOU EVER ASSAULTED ANOTHER PERSON?
(If No, skip to 17.e. If Yes, answer (2) through (7).)
(2) NON-PHYSICAL ALTERCATION
(3) ASSAULT WITHOUT A WEAPON
(4) ASSAULT WITH A WEAPON
(5) MULTIPLE ASSAULTS
(6) AGE AT TIME OF INCIDENT(S)
(7) EXPLAIN INCIDENT(S)
e. HISTORY OF ESCAPE (Assign 6 points in Item 6.e. if answer is Yes to any of the following questions (X one))
NO
YES
(1) HAVE YOU EVER ESCAPED OR ATTEMPTED TO ESCAPE CONFINEMENT?
(2) WERE YOU EVER APPREHENDED ON A PAROLE VIOLATION?
(3) HAVE YOU EVER RESISTED ARREST?
(4) DID YOU EVER INITIATE A PERIOD OF UNAUTHORIZED ABSENCE WHILE OTHER CHARGES WERE PENDING?
DD FORM 2711, MAR 2013
Page 3 of 4 Pages

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