CHC

The most current versions of the DHS background check forms are located below :  

If you subscribe to updates on our site, you will be notified when forms are updated and available online​. Otherwise, please refer to this forms page periodically. 

  
FormName
  
DHS 0299HR
Hearing Request - for Abuse and Criminal Records Checks with Adverse Outcomes (To be used only by DHS or OHA for background checks originating on the 301HR form): (Word)
10/30/2009
MSC 0299
Hearing Request: English: (PDF)
4/18/2018
MSC 0299 Spanish
​Hearing Request: En Español (PDF)
4/18/2018
MSC 0301PFP

Background check request FOR CHILD-CARING AGENCY PROCTOR FOSTER PARENT ONLY. This is a REQUIRED form.  BCU anticipates updating CRIMS to include all CCA-Appl questions some time in 2017.  Scan and attach Section 2 for this form as a document to the Subject Individual's record when submitting in CRIMS: (Word) (PDF)

12/1/2016
MSC 0301PFPi
Background Check Instructions for Child-Caring Agency QEDs for the MSC 0301 CCA-Appl form: (Word) (PDF)
12/1/2016
MSC 0301QED
Background Check RequestQEDS and QEIs are not required to use this form but BCU must receive a signature from the SI, either electronically (the SI completing CRIMS data entry him/herself); or in a scanned copy of this form, signed and dated by the SI.. If you use this form, scan and attach it as a document to the Subject Individual's record when submitting in CRIMS: (Word) (PDF)
8/1/2017
MSC 0301QED Spanish
Background Check Request: En Español: (Word)
8/1/2017
MSC 0301QEDi
Background Check Instructions for Qualified Entity Designees (QEDs): (Word) (PDF)
12/1/2016

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