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This form is required for applicants providing services in the Developmental Disabilities Program (DDP) to authorize background checks and references to establish their qualifications.
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How to fill out DEVELOPMENTAL DISABILITIES PROGRAM PROVIDER REFERENCE AND CRIMINAL BACKGROUND CHECK AUTHORIZATION FORM

01
Obtain the DEVELOPMENTAL DISABILITIES PROGRAM PROVIDER REFERENCE AND CRIMINAL BACKGROUND CHECK AUTHORIZATION FORM from the appropriate agency or website.
02
Read the instructions carefully before starting to fill out the form.
03
Provide your personal information in the designated fields, including your full name, address, and contact details.
04
Fill out any sections related to your employment history, including previous positions and relevant experience in the field of developmental disabilities.
05
Sign the authorization section, granting permission for a background check to be conducted.
06
Ensure all information is accurate and complete before submitting the form.
07
Submit the completed form to the designated agency or organization as instructed.

Who needs DEVELOPMENTAL DISABILITIES PROGRAM PROVIDER REFERENCE AND CRIMINAL BACKGROUND CHECK AUTHORIZATION FORM?

01
Individuals seeking employment or volunteer opportunities within developmental disabilities programs.
02
Providers and organizations that offer services to individuals with developmental disabilities must conduct background checks on employees and volunteers.
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The DEVELOPMENTAL DISABILITIES PROGRAM PROVIDER REFERENCE AND CRIMINAL BACKGROUND CHECK AUTHORIZATION FORM is a document used to authorize the collection of personal information for conducting reference checks and criminal background checks on individuals applying to work with or provide services in developmental disabilities programs.
Individuals applying to be providers, staff, or volunteers in developmental disabilities programs are required to file the DEVELOPMENTAL DISABILITIES PROGRAM PROVIDER REFERENCE AND CRIMINAL BACKGROUND CHECK AUTHORIZATION FORM.
To fill out the form, individuals must provide personal information such as their name, contact details, social security number, and any relevant identification information. There may also be sections to disclose prior employment history or references. After completing the required fields, the individual must sign and date the form to authorize the background check.
The purpose of the form is to ensure the safety and welfare of individuals receiving services in developmental disabilities programs by allowing for thorough background checks on individuals who will work closely with them.
The form generally requires the individual to report their full name, date of birth, social security number, previous addresses, employment history, and the names and contact information of references. It may also include consent for the release of criminal history records.
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