Get Authorization For Release Of Confidential Information - Arkansas ...

This guide provides a step-by-step approach to filling out the Authorization For Release Of Confidential Information form required by the Arkansas Child Maltreatment Central Registry. It is designed to assist users in navigating the online completion of the form, ensuring clarity and accuracy.

Follow the steps to accurately complete your authorization form online.

1. Click the ‘Get Form’ button to access the authorization form and open it in your preferred editing tool.
2. Review the form instructions carefully, particularly those regarding the description and purpose of the request for information from the Arkansas Child Maltreatment Central Registry. Understand the implications of this authorization.
3. In the designated field, check the appropriate box to indicate if you are a Licensed Educator or a Non-licensed Employee/Classified.
4. Enter your contact information accurately. This includes your home phone number, cell phone number, and work phone number. Ensure you provide current and reachable numbers.
5. Print or type your full name in the appropriate section, along with your Social Security number. If applicable, include any maiden names or aliases.
6. Provide your current address and previous addresses if necessary, ensuring you indicate the time periods of residence in each location.
7. List the full names and dates of birth of any children included in this authorization, ensuring accuracy with each entry.
8. Identify the District Contact Person and provide their phone and fax numbers as requested in the designated fields.
9. Fill in the School Mailing Address, School District, and the Local Education Agency (LEA) Number where required.
10. Sign the application at the bottom of the form and indicate the county and date where you are signing. This must also include acknowledgment by a Notary Public.
11. Once all fields are completed accurately, review the document for any errors, and make necessary corrections before saving.
12. Finally, save your changes, and proceed to download, print, or share the completed form as necessary for submission.

Complete your Authorization For Release Of Confidential Information form online today for a smooth submission process.