Files.dcs.tn.gov
|[pic] |Tennessee Department of Children’s Services |
| |Database Search Results |
This form is to be used to request a search of the DCS current child welfare information system database. This request must be typewritten and must be completed for all prospective foster parents, DCS and provider employees who will work with children, and proposed conservators per policy 19.10. NOTE: Requests should be submitted only by persons who are completing foster home studies, persons responsible for completing child protective history search information for prospective employees, or FSWs with a conservatorship case. This form needs to be submitted in WORD format.
| |Date of Request: / / |
|Name: Enter Name of Person Making the Request |Agency: |
|Email: |Telephone: |Fax: |
|Street Address: |
|City: |State: |Zip Code: |
|Enter applicant’s full name. Include in parentheses maiden name, all alias names, and all alternate last names. |
|Full Name: Enter Name of Person Being Researched |Release on file with Agency: |
|Address: |
|Telephone: |Social Security Number: - - |Date of Birth: / / |
|Reason for Search Request: |Specify (if other): |
|Request Category: |If “Recheck Request” explain reason recheck is needed: |
Section below to be completed by DCS ONLY
The following is the database search results for the above referenced person:
| |No evidence was found indicating that the person listed above is substantiated as a perpetrator of child abuse or neglect in Tennessee. |
| |DCS was unable to complete your request at this time. Final results may take 30-60 days. |
| |The results are inconclusive; More specific information is needed to accurately process your request. |
| |Database search records show that the above-listed person is substantiated by DCS for in Tennessee. |
| |The above listed person has not been substantiated by DCS or allegations substantiated against the person occurred more than 2 years ago, with no |
| |further action taken. Therefore, its release is prohibited by Tennessee Comprehensive Rules & Regulations 0250-7-9-.03(5). |
|Search completed by: |Date: |
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