Phone: (612) 294-9000

Fax: (612) 315-4961

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Background Study Consent Form

The following named individual has made an application with First Care Home Care LLC for employment.

I authorize the Minnesota Bureau of Criminal Apprehension to disclose all criminal history record information to FIRST CARE HOME CARE LLC for the purpose of employment.

The expiration of this authorization shall be one year from the date of my signature.

Clear Signature