Child Protective Services History Check Request

Please submit the attached form 0741 to EI_DCS_CPS_CentralRegistryCheck@tn.gov.

• The attached form MUST be typewritten and submitted in Word format.  In the “Reason for Search Request” field, please select “Adam Welsh”.
• Any/all attachments should be submitted as individual documents and NOT as one PDF document.

Submit for EACH applicant for whom you are requesting a search.

1. A cover letter (notice) on your agency’s letterhead stating the reason you are requesting a central registry search. 
2. Attached “Tennessee DCS Database Search Results” form completed in Word format.
3. Copy of current agency license (if a CPA/private adoption agency).  For independent home study writers, please include proof or verification, noting your approval as a home study writer.
4. A copy of the person’s signed “authorization to release information” specifically stating information is to be shared from the Tennessee Department of Children’s Services with your agency. NOTE: This is NOT a TN form.  This is a form that your agency should have, permitting “your” agency to “request” the information and “our” agency (TN Dept. of Children’s Services) to “release” any CPS history information to “you”. 

On the subject line of the email request, please indicate “Out of State Request” along with the applicant’s first initial and last name.

OOS Childcare Requests - State of TN Response to Block Grant Requirement

For making CPS Background History Checks (Child Abuse/Neglect Registry Information) requests:

Please submit the attached form 0741 to CPS.Background.Check@tn.gov.

• The attached form MUST be typewritten and submitted in Word format.  In the “Reason for Search Request” field, please select “Out of State Daycare Employment”.
• Any/all attachments should be submitted as individual documents and NOT as one PDF document.

Requests coming directly from daycare centers should include:

• A copy of the agency’s license
• A statement regarding the age of the children served (if not included in the agency license)
• The applicant/employee’s last known address in the state of Tennessee (date resided at the address if known)

Requests coming directly from state agencies:

• A statement on agency letterhead that notes the applicant/employee’s last known address in TN, along with the dates lived in TN
• Name of the daycare center where the applicant/employee will work/is working in your state (if known)

Whether the request comes directly from a state licensing agency, which requires a statement on letterhead regarding the applicant/employee’s last known address and the name of the daycare center served in your state, or directly from the daycare center, which requires proof of requirement, a copy of the agency’s license and a statement that presents the age of the children served in the daycare setting (if not noted on the agency license) and the applicant’s last known address in Tennessee, along with the timeframe resided at the address (if known), the attached form should be completed and included with all requests.

All requests should be sent to  CPS.Background.Check@tn.gov.

On the subject line of the email request, please indicate “Out of State Request” along with the applicant’s first initial and last name.

For making CPS Background History Checks (Child Abuse/Neglect Registry Information) requests:

Please submit the attached form 0741 to  EI_DCS_CPS_CentralRegistryCheck@tn.gov.

The attached form MUST be typewritten and submitted in Word format.  In the “Reason for Search Request” field, please select “Family First (FFPSA)”.

Any/all attachments should be submitted as individual documents and NOT as one PDF document.

Requests coming directly from Child Care Institutions should include:

• A copy of the agency’s/treatment facility’s/group home license
• The applicant/employee’s last known address in the state of Tennessee (date resided at the address if known)

Requests coming directly from state agencies:

• A statement on agency letterhead that notes the applicant/employee’s last known address in TN, along with the dates lived in TN (if known)

Whether the request comes directly from a state licensing agency, which requires a statement on letterhead regarding the applicant/employee’s last known address, or directly from the Child Care Institution (CCI), which requires a copy of the agency’s license and the applicant’s last known address in Tennessee (if known), the attached form should be completed and included with all requests.

All requests should be sent to  EI_DCS_CPS_CentralRegistryCheck@tn.gov.

On the subject line of the email request, please indicate “Out of State Request (per Family First)” along with the applicant’s first initial and last name.

Please submit to EI_DCS_CPS_CentralRegistryCheck@tn.gov the name(s), birth date(s) and social security number(s) for any person(s) on whom you have an OPEN investigation.  The request should be submitted on the agency letterhead and should state the reason you are submitting the request.  If agency letterhead is not available, the request must be submitted from an email address associated with your agency along with a copy of your work i.d. badge.  

Note: Requests for Central Registry Searches are completed on identified alleged perpetrators or alleged child victims, only.  If you are submitting this request because you have an intake referral or ongoing family service case or other types of social services involvement, please advise.

*** (For Law Enforcement Agencies – information is shared for open criminal matters involving children as the victim of a crime) ***