Three forms are required for fingerprint-based criminal background checks for adult foster care providers, agency foster homes for adults owners and staff members, all adults residing in adult foster care that are not receiving care, respite providers, and substitute caregivers.
Please note: Not all forms are compatible with Mac programs.
Instructions - How to submit a background check request.
Agency Foster Home Staff
Adult Foster Care Provider, Household Members, and Agency Foster Home Owner
Handbooks
Adult Foster Care Provider Handbook
Agency Foster Home for Adults Handbook
Form 1
Personal Authorization for Criminal History Record Information Inquiry (SFN 467) (This form must be typed)
(Agency Foster Home Staff ONLY ~ all others go to QSP Portal (https://ndhousingstability.servicenowservices.com/nd_qsp)
Additional Address History
(Use as needed and attach along with SFN 467)
Form 2a
Criminal History Record Check Request Form (Fingerprint-Based) (SFN 60688)
(This form must be typed)
Form 2b
Criminal History Record Check Request Form (ND State Only) (SFN 60688)
(This form must be typed)
Form 3
Fingerprint Identity Verification (SFN 836)
(Print a blank copy of this form)
Contact Information
Criminal Background Check Unit
600 E. Boulevard Avenue, Department 325
Bismarck, ND 58505-0250
Phone: (701) 328-7575
Toll-Free: (800) 472-2622, 711 (TTY)
Fax: (701) 328-0358
Email: dhscfscbc@nd.gov