Mdhs form 3336-2026

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The document is a form used by the Mississippi Department of Human Services (MDHS) to request a check of the Child Abuse Central Registry for various applicants, including those seeking foster/adoption placements, MDHS employment, or volunteer internships. It emphasizes the confidentiality of the information and requires a signed release from the applicants. The form includes sections for applicant details and findings from the registry.

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Click ‘Get Form’ to open the mdhs form 3336 in the editor.
Begin by entering the date at the top of the form. This is essential for record-keeping.
In the 'TO' section, fill in the name, title, agency, and address of the recipient who will be checking the central registry.
Next, specify the purpose of your request by checking one or more boxes: Foster/Adoption, MDHS Employee, Relative Resource Parent, etc.
Complete the applicant's details by printing their name, address, date of birth (DOB), social security number, and a contact telephone number.
Acknowledge confidentiality by signing that you have a release form on file from the applicants. This ensures compliance with privacy regulations.
Finally, leave space for findings to be filled out by MDHS staff and ensure you sign and date where indicated.

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