Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the Missouri Caregiver Background Screening and open it for completion.
2. In Block I, begin by checking the appropriate boxes in Section A to indicate the type of screening you are requesting. Be sure to select all applicable options, as they determine which background checks will be conducted.
3. Fill out Section B with your personal information as the requestor. Provide your name, telephone number, address, city, state, ZIP code, and a signature in ink, along with the date.
4. In Block II, Section C, the caregiver must enter their identifying data. This includes their full name (last, first, middle initial, any suffix), social security number, maiden name, date of birth, state of birth, sex, race, and any aliases they may have used.
5. Section D requires the caregiver’s authorization to release their information. They should read the statement carefully, sign it in the presence of a notary public, and date it accordingly.
6. If the caregiver is opting for the child abuse or neglect file screening, Section E must be completed by a notary public. This includes the notary’s seal, signature, and the commission expiration date.
7. In Block III, the requestor must ensure to enter their return address information accurately. This is where the responses will be sent.
8. Once all the sections are completed, reviewers should double-check all the entered information for accuracy before saving their changes. After verification, the form should be printed for submission.

Complete your caregiver background screening online today for a smoother application process.