Homepage / Fill in a Valid Delaware Child Protective Registry Template
Jump Links

The Delaware Child Protective Registry form is a critical tool designed to help maintain the safety and well-being of children within the state. This form facilitates the collection and dissemination of essential information regarding individuals who may have a history of child abuse or neglect. By completing this form, an applicant can authorize the Delaware Department of Services for Children, Youth, and Their Families to share all pertinent substantiated cases with a designated requester. The registry plays a vital role in ensuring that organizations and individuals working with children can make informed decisions based on an applicant's history. Within the form, applicants are required to provide personal details such as their names, social security number, date of birth, and address. Furthermore, individuals must disclose whether they have any existing substantiated cases of child abuse or neglect on the registry. This aspect of the form underscores the importance of transparency and accountability. Applicants must also sign and date the form, indicating their consent to the release of their information, which helps establish a clear line of communication between the involved parties. Following these guidelines is crucial, as requests must be submitted within 90 days of signing to ensure timely processing. In addition to personal information, the form also includes sections for the requester, distinguishing between agency requests and individual requests, ensuring that all necessary stakeholders have the appropriate access to vital information. This comprehensive approach underlines the state's commitment to protecting Delaware's children while balancing individuals' rights to privacy and information dissemination.

Delaware Child Protective Registry Example

DELAWARE CHILD PROTECTION REGISTRY CONSENT FORM

Web Portal

Instructions

Complete the below form and fax or email directly to the Division of Professional Regulation at the contact information below:

Fax: (302) 739-2711

DE Application Number: APP-__________________

Email: [email protected]

 

Request must be within 90 days of signature date in order to be processed

PART I - APPLICANT INFORMATION

Name (Last*, First*, Middle): *___________________________, *_________________________, __________________

Other Name(s) used:

None ________________________________________________________________________

Social Security #: ________ - ________ - ___________

Date of Birth (mm/dd/yyyy)*: _____ - _____ - _______

Gender*:

Male

Female

Race: ______________________________________

Ethnicity: Hispanic

Non-Hispanic

Address (Street, City, State, Zip): ______________________________________ _______________ _____ __________

Are you on the Delaware Child Protection Registry for any substantiated cases of child abuse/neglect?

Yes

No

If yes, explain:_____________________________________________________________________________________

I hereby authorize The Delaware Department of Services for Children, Youth and Their Families to provide the below named requester with all substantiated cases of child abuse or neglect concerning me that are active on the Delaware Child Protection Registry. I further release the Delaware Department of Services for Children, Youth and Their Families, 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: ____________________________________________

Date: __________________

Parent/Guardian Signature (If applicant is under the age of 18): ______________________________________________

PART II - REQUESTER INFORMATION

Check one option below and complete required information*:

1. Agency Request – Agency Name*: DIVISION OF PROFESSIONAL REGULATION

2. Individual Request - Self

*Mandatory

Revised 6/2020

File Breakdown

Fact Name Description
Governing Law The Delaware Child Protection Registry is governed by Delaware law, specifically Title 16, Chapter 929.
Purpose This form is used to request information regarding an individual's status on the Delaware Child Protection Registry.
Submission Methods Submissions can be made via fax at (302) 739-2711 or email to [email protected].
Applicant Information Applicants must provide their full name, Social Security number, date of birth, and other identifying information.
Confidentiality The form includes a consent section where the applicant releases the Delaware Department of Services for Children, Youth and Their Families from any claims related to the information released.
Request Timeframe Requests for information must be made within 90 days of signing the form to ensure processing.
Substantiated Cases Applicants must disclose whether they are on the registry for any substantiated cases of child abuse or neglect.
Age Requirement Individuals under 18 must have a parent or guardian sign the consent form alongside their own signature.
Ethnic Disclosure The applicant is required to indicate their race and ethnicity on the form.
Revised Date The last revision of the form occurred in June 2020, ensuring it reflects current practices and regulations.

Guide to Using Delaware Child Protective Registry

Filling out the Delaware Child Protective Registry form is a straightforward process. After completing the form, it must be submitted via fax or email to the Division of Professional Regulation. Ensure the request is made within 90 days of signing the form to guarantee timely processing.

  1. Obtain the Delaware Child Protective Registry consent form.
  2. Fill in the required sections in Part I: Applicant Information.
    • Enter your Last, First, and Middle names in the designated fields.
    • If applicable, list any other names you have used.
    • Provide your social security number in the format of XXX-XX-XXXX.
    • Input your date of birth using the format (mm/dd/yyyy).
    • Select your gender: Male or Female.
    • Indicate your race and ethnicity as needed.
    • Fill in your address, including street, city, state, and zip code.
    • Answer whether you are listed on the Delaware Child Protection Registry for any cases of child abuse or neglect by choosing 'Yes' or 'No.'
    • If you answered 'Yes,' provide an explanation for the substantiated case(s).
    • Sign and date the form. If under 18, have a parent or guardian sign it as well.
  3. Proceed to Part II: Requester Information.
    • Choose one of the two options: Agency Request or Individual Request.
    • If selecting Agency Request, fill in the name of the agency: DIVISION OF PROFESSIONAL REGULATION.
    • If selecting Individual Request, indicate that it is a request for yourself.
  4. Verify that all information is accurate and complete.
  5. Fax the completed form to (302) 739-2711 or email it to [email protected].

Get Answers on Delaware Child Protective Registry

What is the Delaware Child Protective Registry form?

The Delaware Child Protective Registry form is a document used by individuals to request information regarding their status on the Child Protection Registry. This registry maintains records of substantiated cases of child abuse or neglect, ensuring that those who work with children can be properly reviewed and monitored.

Who needs to fill out this form?

Anyone who wishes to check their own status on the Delaware Child Protection Registry should fill out this form. This includes individuals who may have reasons to know if there are any substantiated claims against them related to child abuse or neglect. Additionally, agencies may also request this information for individuals they employ or are considering for employment.

How do I submit the Delaware Child Protective Registry form?

To submit the form, complete all required sections and then fax or email it to the Division of Professional Regulation. The fax number is (302) 739-2711, and you can email your request to [email protected] .

Is there a time limit for submitting the request?

Yes, the request must be made within 90 days of the date you sign the form. Make sure to pay attention to this time frame to ensure that your request can be processed without any issues.

What information do I need to provide?

You will need to provide personal details, including your name, Social Security number, date of birth, gender, race, and ethnicity. If applicable, you must also disclose any other names you may have used. For applicants under 18, a parent or guardian's signature is required as well.

What happens after I submit my request?

Once your request is submitted, the Delaware Department of Services for Children, Youth and Their Families will process it and provide the requested information regarding any substantiated cases against you. You can expect a response within a reasonable time frame depending on their workload.

What if I am found on the registry?

If you are found to be on the Delaware Child Protection Registry for substantiated cases, the specific details may be shared with authorized individuals or agencies that request the information. It is important to reflect on your rights and consider seeking legal advice if needed.

Can someone else submit the form on my behalf?

Yes, someone else can submit the form on your behalf as long as they meet the requirement of being an agency representative or have your consent as an individual requester. Ensure they have all the required information to accurately complete the form and submit it properly.

How can I ensure my information is secure?

Your privacy is important. The Delaware Department of Services for Children, Youth and Their Families is responsible for maintaining the confidentiality of the information you provide. Make sure you submit your information only through the official channels provided, and discuss any concerns about your data security with them directly.

Where can I find more information about the Delaware Child Protective Registry?

For more detailed information, you can visit the official website of the Delaware Department of Services for Children, Youth and Their Families. This resource provides additional context and guidance about the registry and related processes.

Common mistakes

Filling out the Delaware Child Protective Registry form is an important task, but it's easy to make mistakes. Many applicants overlook key sections, which can delay or prevent their registration. Here are five common mistakes to watch out for.

One major error occurs in the personal information section. Applicants sometimes forget to include their middle name or only provide their last and first names. This can lead to confusion, especially if there are multiple applicants with similar names. Always double-check that all required names are filled out completely.

Another frequent mistake is incomplete or incorrect social security numbers. This number is crucial for identifying individuals in the registry. Leaving any part of it blank or miswriting digits can result in processing delays. It’s essential to enter your social security number carefully and ensure it matches what’s on your official documents.

Some people overlook the authorization section. This part requires a clear declaration allowing the Delaware Department of Services for Children, Youth and Their Families to release information about any substantiated cases. Not signing this section means your request may be rejected outright. Make certain you sign and date the form, especially if you are a minor and need a parent or guardian’s signature.

Many applicants fail to respond to the question about whether they are on the Child Protection Registry for any substantiated cases of child abuse or neglect. This inquiry is important for transparency. If you answer 'yes,' provide a detailed explanation as requested. Skipping this detail can complicate your request.

Lastly, a common oversight is not checking the submission method. The instructions specify either faxing or emailing. Be sure you use the correct contact information and confirm that your form was received. Sending it in a different way may result in it not being processed at all. Following the instructions carefully will help ensure your form is processed smoothly.

Documents used along the form

The Delaware Child Protective Registry form is an essential document for individuals seeking to understand their status concerning child protection allegations in the state of Delaware. Alongside this form, there are several other important documents that may be utilized during the process. Each of these documents serves a distinct purpose in ensuring compliance with child protection laws and enhancing the efficacy of the registry process.

  • Child Abuse and Neglect Reporting Form: This form is used by individuals to report suspected child abuse or neglect to the appropriate authorities. It typically includes details about the child, the circumstances of the suspected abuse, and the identity of the reporter.
  • Background Check Authorization Form: Often required by employers or agencies working with children, this form allows for a formal background check to be performed. It usually asks for personal information, including social security number and consent to access criminal records.
  • Fingerprinting Consent Form: A specific consent form that allows law enforcement or designated agencies to collect fingerprints for background checks. This is particularly important for those seeking employment in positions that involve working with children.
  • Substantiated Case Review Request Form: Individuals may use this form to request a review of their case if they believe it has been incorrectly categorized as substantiated. It outlines the necessary details for a formal review by relevant authorities.
  • Child Protection Services Release Form: This document authorizes the release of information regarding child protection cases. It is crucial for maintaining transparency while safeguarding the privacy of those involved.
  • Appeal Form: If an individual disagrees with a decision made regarding their status in the Child Protective Registry, this form allows them to formally appeal the decision. It typically requires detailed reasoning and supporting documentation.
  • Child Welfare Monitor Form: Used by agencies to monitor ongoing cases of child abuse or neglect. This form helps track interventions and ensure the child’s safety and well-being.
  • Consent to Release Medical Records Form: When health issues arise in cases of child abuse or neglect, this form allows healthcare providers to release relevant medical information to child protective services, if necessary.
  • Training Certification for Mandated Reporters: Individuals who are legally required to report suspected child abuse must often present proof of training. This certification shows that they have received the required education on recognizing and reporting abuse.

Each document plays a critical role in the realm of child protection, ensuring that the rights and safety of children are prioritized. It is important for individuals to familiarize themselves with these forms to navigate the process effectively and responsibly.

Similar forms

  • Child Abuse Background Check Form: This document allows individuals to request a background check specifically related to child abuse reports. Similar to the Delaware Child Protective Registry form, it requires personal information and details regarding any past allegations of child abuse or neglect. It requires consent for the release of information pertaining to one’s history.
  • Sex Offender Registry Consent Form: This form is designed for individuals to consent to a background check against the sex offender registry. Like the Child Protective Registry form, it involves personal data and offers individuals the opportunity to review any allegations made against them. Consent is crucial for the sharing of information found in these records.
  • Foster Care Licensing Application: This application is required for individuals seeking to become licensed foster parents. It shares similarities with the Delaware Child Protective Registry form in that it collects comprehensive personal information and examines any relevant history regarding child protection concerns. The application must be thoroughly completed to be considered valid.
  • Criminal Background Check Request Form: Individuals use this form to request a check of their criminal history. It resembles the Child Protective Registry form by requiring personal identification and risk disclosure related to past conduct. Consent is necessary for access to this sensitive information, emphasizing accountability.

Dos and Don'ts

When filling out the Delaware Child Protective Registry form, keep these important tips in mind:

  • Do: Ensure all personal information is accurate and complete, including your name, Social Security number, and date of birth.
  • Do: Submit your application within 90 days of signing to ensure timely processing.
  • Do: Indicate any other names you have used to avoid delays in processing.
  • Do: Sign and date the form; without your signature, the application cannot be processed.
  • Don't: Leave any required fields blank; incomplete forms may be rejected.
  • Don't: Provide false information or omit any substantiated cases of child abuse/neglect.
  • Don't: Forget to include your contact information for any follow-up inquiries.
  • Don't: Use an unverified email or fax number; always use the official contact details provided.

Misconceptions

  • Myth: Filling out the form guarantees automatic approval. The Delaware Child Protective Registry form does not guarantee acceptance. Each request is subject to review and must comply with state guidelines.
  • Myth: The registry is only for individuals with a criminal history. This form is relevant to anyone, regardless of their background, who wishes to check their status on the registry for any substantiated cases of child abuse or neglect.
  • Myth: You can submit the form at any time. Requests must be made within 90 days of signing the form. Submissions after this period may not be processed.
  • Myth: You need a lawyer to fill out the form. The form is straightforward and can be completed by individuals without legal representation. However, seeking advice can be helpful if there are concerns.
  • Myth: Only certain professionals can request information from the registry. Both agencies and individuals can request information regarding their own cases on the registry. Individuals should select the relevant option when filling out the form.
  • Myth: Submissions only need to be faxed. The form can be sent via email or fax to the Division of Professional Regulation. This provides flexibility to applicants.
  • Myth: Once on the registry, you cannot have your name removed. Individuals might have opportunities for appeals or reviews based on certain circumstances, allowing for the possibility of removal.
  • Myth: The registry only tracks abuse cases. The registry includes substantiated cases of both child abuse and neglect, reflecting a broader scope of child welfare concerns.

Key takeaways

  • To begin the process, complete the Delaware Child Protective Registry Consent Form accurately.
  • The form must be submitted either via fax or email directly to the Division of Professional Regulation.
  • Provide your DE Application Number, which will be important for tracking your request.
  • All information provided must be within 90 days of the signature date to ensure processing.
  • Include your Social Security Number, date of birth, and gender; this information is crucial for identification.
  • If you have ever been on the Delaware Child Protection Registry for any substantiated cases, you need to indicate this on the form.
  • You are required to authorize the Delaware Department of Services for Children, Youth and Their Families to release your information as necessary.
  • For applicants under 18, a parent or guardian must provide their signature along with the applicant's.