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Programs & Services

When a background check revealed a criminal conviction (including a deferred judgement), founded child or dependent adult abuse, or a combination thereof, complete the Record Check Evaluation form in black ink or typed.

Record Check Evaluation Spanish

Evaluation materials may be submitted via email, fax or mailed to:

Iowa Department of Health and Human Services

Record Check Evaluations

P.O. Box 4826

Des Moines, IA 50305-4826.

Currently processing forms received on May 23, 2024.