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The Office of Human Resource Development and Management’s Background Investigations Unit was formed in July 1999 to execute the criminal background check process for the Department of Mental Health, Mental Retardation and Substance Abuse Services Licensed Private Providers, as mandated by the Virginia Code § 37.2-416. The Background Investigations Unit conducts criminal background checks for applicants who accept employment in direct consumer care positions.

Procedures, forms and/or attachments can be requested by one of the following methods:

• Contact 804-786-6384 ~ Malinda Roberts
• Email malinda.roberts@co.dmhmrsas.virginia.gov
• Forms and/or attachments may also be downloaded from this site

• Form #001 ~ DMHMRSAS’ Licensed Providers Contact & Information Sheet
• Form #002 ~ Statement of Authorization of Payment to DMHMRSAS
• Form #003 ~ Criminal Background Investigation Request Checklist
• Form #005 ~ Fingerprint Card Request Form
• Form BIUSP-167 - Criminal History Record Name & Sex Offender Search Request 

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• Attachment 2 ~ “Barrier Crimes”
• Attachment 3 ~ Disclosure Statement
• Attachment 4 ~ Authority for Release of Information
• Attachment 5 ~ Request for Criminal Background Check
• Attachment 11 ~ Applicant’s Rights
• Attachment 14 ~ “Applicant Arrest/Conviction Data”
• Attachment 17, Part I ~ Private Provider Request to Discontinue Reprints

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• Fingerprint Card Template
• Attachment 7 ~ Race, Eye & Hair Color Codes

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Packets should include the following, in this order:

Fingerprints:

1. One Form #003
2. Organization check or money order*
3. Attachments 3, 4 & 5 ~ stapled together in order
4. One fingerprint card ~ paper clipped to corresponding applicant's attachments

Name & Sex Offender Searches:

1. Organization check or money order*
2. Form BIUSP-167 ~ completed by the individual, provider and notary

*Write a separate check for each type of investigation: Criminal Background or Name & Sex Offender Search.

Send all requests to:        DMHMRSAS
                                            Background Investigations Unit
                                            P.O. Box 1797
                                            Richmond, VA 23218-1797

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Name	Title or Address	Phone
Stephanie Willinger	Manager	804-786-5858
Malinda Roberts	Supervisor	804-786-6384
Background Investigations Unit Address	DMHMRSAS                                            Background Investigations Unit P.O. Box 1797 Richmond, VA 23218-1797
Physical Address	1220 Bank Street Jefferson Building, 3rd Floor Richmond, VA  23219	804-786-1078 (Main)
DMHMRSAS Mailing Address	P.O. Box 1797 Richmond, VA 23218-1797	804-786-4146 (Main Fax)

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