Form DHR-FCS-1598 at a glance
What it is: CENTRAL REGISTRY CLEARANCE: a search to determine if the person identified has been named as being responsible for child abuse or neglect in Alabama; DHR releases only information necessary to discover or prevent it.
Who signs: To be completed by person being cleared: Signature with a Date and Signature of Witness with a Date. The requestor also signs: the Requestor Signature and the Witness Signature each have a Date.
A filled-in Form DHR-FCS-1598 example: a day care center clears a new employee

How to fill out Form DHR-FCS-1598, box by box
Requesting Person or Agency/Organization

Under Requesting Person or Agency/Organization, check all that apply.
Check from Child Placing Agency, Residential Child Care Facility, Child Day / Night Care Center, Family Day / Night Care Home, Exempt Child Day Care Center, Medicaid Rehab. Provider, DHR Vendor and Other (Please Specify).
Enter the Mailing Address, the Telephone Number and the Email.
PRINT the Requestor's Name; the Requestor Signature and the Witness Signature each have a Date.
The person who will provide care

Name and identifying information of the person who will provide unsupervised care and supervision of children as an employee, volunteer or other (check it), printed or typed; write this person's specific job/role.
Enter the Name (Last, First, Middle), Sex (Male or Female), Race and DOB.
Enter the Current Mailing Address, the Alias, Maiden & Prior Married Name(s), the Name & DOB of Spouse & Former Spouse(s), the Name & DOB of Children / Stepchildren and the Alabama counties where the person has lived and/or worked.
"Attach additional pages as needed to provide all information requested above."
To be completed by person being cleared

To be completed by person being cleared: authorize the Alabama Department of Human Resources to release information contained in the Child Abuse / Neglect Central Registry about the person to the named person/agency/organization. Also waive any right to any review or hearing, and release the Department of Human Resources, its officers and employees from any and all claims arising out of or connected to the release. Then sign with a Date and a Signature of Witness with a Date.
More rules for Form DHR-FCS-1598
A search of the Alabama Child Abuse / Neglect Central Registry has been completed with the information provided to determine if the person identified 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.
To be completed by DHR: Substantiated report (i.e., indicated) located. See attached information. Type Report: Physical Abuse, Neglect, Sexual Abuse, Mental Abuse / Neglect. No report located. Request Denied. Other. Office of Child Protective Services, Date Completed.
Sources
[1] Form DHR-FCS-1598 (Revised December 2009), Child Abuse / Neglect Central Registry Clearance, Alabama Department of Human Resources (the Official source link on this page).
