Get Fillable 0301 Qed

This guide provides a comprehensive overview of filling out the Fillable 0301 Qed form online. The form is essential for conducting background checks and gathering necessary information. Follow these instructions carefully to ensure a smooth submission process.

Follow the steps to accurately complete the Fillable 0301 Qed form.

1. Press the ‘Get Form’ button to access the Fillable 0301 Qed form and open it in your preferred editor.
2. In Section 1, enter the QED agency name, street address, city, state, and ZIP code. Fill in your name and contact information accordingly.
3. Select the appropriate application type from the options provided, and indicate if it pertains to a skilled position in a nursing facility.
4. Provide the start date for the position and specify whether this is a recheck of the subject individual (SI) for the same position.
5. Enter the position title and a brief description of the duties associated with it.
6. Indicate any direct contact requirements the position entails, such as working with children or handling confidential information.
7. Inquire if the job duties require driving and check the appropriate box.
8. List the types of documents that will be checked to verify the SI's identity and provide the initials of the person verifying the ID.
9. Input the worksite location(s) for the position; include all relevant addresses if multiple locations exist.
10. In Section 2, the SI must provide their complete name, Social Security number (if applicable), date of birth, email address, and gender.
11. Fill in the driver's license information, including the state and number, along with any aliases or other names used.
12. Complete the residence and mailing address sections, ensuring to check the box if correspondence should be sent to the mailing address instead of the email.
13. Provide all relevant phone numbers for contact purposes.
14. Indicate if the SI has lived outside Oregon for more than 60 consecutive days in the last five years and provide details if applicable.
15. Disclose any criminal history, ensuring to include all necessary details for each incident.
16. If applicable, attach additional pages with details about the SI's history and any mitigating factors.
17. Sign and date the form to complete the SI's section.
18. In Section 3, the QED must answer questions regarding the SI's disclosed criminal history and other relevant checks.
19. Finally, complete the QED's signature and date before submission.
20. After filling out the form, you can save changes, download, print, or share the completed document as needed.

Ensure your application process goes smoothly by completing the Fillable 0301 Qed form online today.