Alabama Central Registry Clearance PDF Details

Alabama Central Registry Clearance is required for individuals who want to become foster parents in the state of Alabama. The clearance verifies that the individual does not have a history of child abuse or neglect. This article will provide more information on the clearance process and how to obtain it. If you are interested in becoming a foster parent in Alabama, you must first obtain clearance from the Alabama Central Registry (ACR). The ACR is a statewide registry that maintains information on individuals who have been accused or convicted of child abuse or neglect. The clearance verification confirms that you do not have a history of child abuse or neglect and allows you to proceed with the application process to become a foster parent.

The table provides information regarding the alabama central registry clearance. It could be useful to learn its size, the average time required to fill out the form, the blanks you'll have to fill in, and so forth.

Form NameAlabama Central Registry Clearance
Form Length1 pages
Fillable fields37
Avg. time to fill out7 min 43 sec
Other namesdissemination, dhr can report, how to get a can central registry clearance done in alabama, alabama central registry clearance form

Form Preview Example



PRINT OR TYPE in black or blue ink. Additional information regarding the CA/N Central Registry is on the back of this form.

** See instructions for the address to use when submitting this form. **

Requesting Person or Agency/Organization



Check All That Apply







Mailing Address





Child Placing Agency












Residential Child Care Facility












Child Day / Night Care Center







Telephone Number (





Family Day / Night Care Home







PRINT Requestor’s Name





Exempt Child Day Care Center












Medicaid Rehab. Provider






DHR Vendor












Other (Please Specify)












The person whose name and identifying information, printed or typed below, will provide unsupervised care and

supervision of children as an



other. This person’s specific job/role is or will be:



Name _____________________________________________ Sex

Last First Middle


Race ___________ DOB ___/___/______



Current Mailing Address


Alias, Maiden & Prior Married Name(s)


Name & DOB of Spouse & Former Spouse(s)


Name & DOB of Children / Stepchildren


Alabama counties where person has lived and/or worked


Attach additional pages as needed to provide all information requested above.

To be completed by person being cleared

I authorize the Alabama Department of Human Resources to release information contained in the Child Abuse / Neglect Central Registry about me to the above named person/agency/organization. I hereby waive any right to any review or hearing to which I may otherwise be entitled. I further release the Department of Human Resources, its officers, and employees from any and all claims arising out of or in any way connected to the release or dissemination of any information concerning me.







Signature of Witness


To be completed by DHR

A search of the Alabama Child Abuse / Neglect Central Registry has been completed with the information provided to determine if the person identified above has been named as being responsible for child abuse or neglect in Alabama. DHR releases only that information which is necessary to discover or prevent child abuse / neglect.

Substantiated report (i.e., indicated) located. See attached information.

Type Report:

Physical Abuse


Sexual Abuse

Mental Abuse / Neglect

No report located.





Request Denied


Other _________________________________________________________________________________________



Office of Child Protective Services



Date Completed

DHR-FCS-1598 (Revised December 2009)

How to Edit Alabama Central Registry Clearance Online for Free

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step 1 to completing alabama child abuse registry

Indicate the details in Name, Middle, First, Last, Sex, Male Female, Race ___________ DOB ___/___/______, Current Mailing Address, Alias, Name & DOB of Spouse & Former, Name & DOB of Children /, Alabama counties where person has, Attach additional pages as needed, To be completed by person being, and I authorize the Alabama Department.

alabama child abuse registry Name, Middle, First, Last, Sex, Male Female, Race ___________ DOB ___/___/______, Current Mailing Address, Alias, Name & DOB of Spouse & Former, Name & DOB of Children /, Alabama counties where person has, Attach additional pages as needed, To be completed by person being, and I authorize the Alabama Department fields to complete

Mention the important details in I authorize the Alabama Department, _________________________________, ________________ Date, _________________________________, ________________ Date, A search of the Alabama Child, Substantiated report (i, Type Report:, Physical Abuse, Neglect, Sexual Abuse, Mental Abuse / Neglect, No report located, Request Denied, and Other box.

part 3 to entering details in alabama child abuse registry

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