Get Conviction/criminal History Information Form - University Of ... - Depts Washington

Navigating the Conviction/Criminal History Information Form for the University of Washington's School of Pharmacy can be crucial for your application process. This guide provides clear instructions to help you accurately complete the form online, ensuring that all necessary information is provided.

Follow the steps to fill out the form correctly.

1. Press the ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Carefully review the instructions at the top of the form to ensure you understand the purpose and requirements for submission.
3. Begin filling in your personal details, including your name (last, first, middle), social security number, maiden name or aliases, date of birth, phone number, and email address. Make sure all information is accurate.
4. Proceed to the section regarding crimes against persons and financial exploitation. Indicate whether you have ever been convicted of any of the listed crimes by selecting 'YES' or 'NO.' If you select 'YES', check all applicable offenses and provide additional details in the provided box.
5. Include your responses for drug-related crimes by answering the relevant question regarding convictions related to controlled substances.
6. Answer the related proceedings section, indicating any past findings in dependency, domestic relations, disciplinary proceedings, or protection proceedings that involve sexual or financial exploitation.
7. Complete the section related to healthcare crimes, responding to all questions regarding convictions and civil monetary penalties connected to Medicare/Medicaid.
8. In the general conviction information section, disclose any other convictions within the past ten years, excluding minor traffic citations, and provide details as required.
9. Review the entire form for accuracy and completeness. Ensure that all required fields are filled out and any additional pages are attached where necessary.
10. Sign and date the form, certifying that the information provided is true and complete. Make sure to keep a copy for your records.

Take action today by completing your Conviction/Criminal History Information Form online to ensure a smooth application process.