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Iowa dhs record check evaluation 2026

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  1. Click ‘Get Form’ to open the Iowa DHS Record Check Evaluation in our editor.
  2. In Section A, enter the details of the agency, provider, or person requesting the evaluation. Fill in the requestor’s name, phone number, fax number, and complete address including city, state, and zip code.
  3. Proceed to Section B where you will input information about the person being evaluated. Include their last name, first name, middle initial, any maiden or previous names, and the role or position they are applying for.
  4. In Section D, provide a detailed explanation of each crime or abuse. Include dates, locations, relationships to victims, ages of victims, and your actions. You may attach additional sheets if necessary.
  5. Lastly, ensure all supporting documents such as treatment certificates and reference letters are included before submitting your completed form.

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Iowa Code r. 481-67.19 - Criminal, dependent adult abuse

Evaluation means review by the department of human services to determine whether a founded child abuse, dependent adult abuse or criminal conviction warrantsRead more

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