Follow the steps to complete the Twice Blessed House Resident Screening Agreement.

1. Press the ‘Get Form’ button to access the Twice Blessed House Resident Screening Agreement. This will enable you to open the form in your preferred online editor.
2. Provide your printed name in the space provided. Ensure that your name is entered accurately as it appears on legal documents.
3. If applicable, fill in any maiden or other last names you have used in the designated area. This helps in verifying your identity.
4. Enter your home street address, ensuring you do not use a P.O. Box number. This address should be where you currently reside.
5. Input your date of birth in the specified format, which helps in verifying your age and identity.
6. Provide your Social Security Number (SSN) in the field provided. This information is crucial for the background check.
7. Enter your driver’s license number in the appropriate space. Ensure that the number is accurate to avoid complications.
8. Indicate the state that issued your driver’s license in the designated field.
9. Fill in your contact phone number. It is important that this number is current, as you may be contacted regarding your application.
10. Select your role by checking the appropriate box — either 'Patient' or 'Caregiver'. This is important for processing your application.
11. If you are a caregiver, specify which patient you are supporting by entering their name in the space provided.
12. Sign and date the form at the bottom. Your signature confirms your agreement to the screening process.
13. After completing the form, you can fax it to the number provided (214-820-6545) or mail it to the listed address: 2732 Gaston Ave. #119, Dallas, TX 75226.

Complete your Twice Blessed House Resident Screening Agreement online today!