Get Iowa Health Care Facility 135c Record Check Form C

Filling out the IOWA HEALTH CARE FACILITY 135C RECORD CHECK Form C online is an essential step for requesting criminal history information. This guide provides clear instructions to help you navigate the form effectively and ensure all necessary details are completed accurately.

Follow the steps to successfully complete the form

1. Click the ‘Get Form’ button to access the form and open it in the editor.
2. Begin by entering the account number in the designated field at the top of the form.
3. In the 'TO' section, confirm the address of the Iowa Division of Criminal Investigation. Ensure that the information matches the official address provided.
4. Next, fill out the 'FROM' section with your organization's name (e.g., Longhouse-Northshire) and contact details including phone and fax numbers.
5. In the 'REQUEST' section, provide the necessary personal information of the individual for whom you are requesting the criminal history check. Fill out the last name, date of birth, first name, middle name, and maiden name if applicable.
6. Complete the sex and social security number fields. The latter is mandatory, so ensure accuracy.
7. In the signature section, the requester must sign to certify the request.
8. If applicable, fill out the 'RESULTS' section with findings from the criminal history check and the necessary signatures for internal use.
9. Finally, sign and date the waiver section to permit the Division of Criminal Investigation to conduct the check.
10. Once all fields are completed, you can save changes, download, print, or share the form as needed.

Start filling out your IOWA HEALTH CARE FACILITY 135C RECORD CHECK Form C online today!