Revised CHRC Form Posted 

Situation Report | April 12, 2021

The state Department of Health (DOH) has updated the “Acknowledgement and Consent for Fingerprinting and Disclosure of Criminal History Record Information” form with a DOH form number.

The updated form, labelled DOH-102, may be found on the Criminal History Record Check (CHRC) application under “Acknowledgement and Consent for Fingerprinting and Disclosure of Criminal History Record Information.” Translations are also available in Bengali, Chinese Simplified, Haitian Creole, Korean, Russian, and Spanish.

If you have questions regarding the revised form, contact DOH via the “Contact CHRC” button on the top right-hand corner of the CHRC application for further clarification.