forms


To request a background screening, please submit the completed Child Abuse Registry Request Form along with a copy of your driver’s license to the email address on the top of the form, or fax to 801-538-3993. For additional information, or questions, please contact the Background Screening Specialist at 801-538-4466 or dcfscentralregistry@utah.gov


All requests for records must be submitted in accordance with the Utah Government Records Access and Management Act (GRAMA). This refers to the state statutes governing the privacy of records and when they can be released. For additional information, visit Archives.utah.gov.

Provider-Only Payment Forms


To request a one-time/special needs payment, complete the DHS-DCFS One-Time Provider Form 295F form and submit it to your caseworker.


To submit an invoice for services provided, complete the DCFS 520 form and submit it to your caseworker.


Complete the Foster Parent Private Vehicle Usage Report for mileage reimbursement and submit it to your caseworker.


If you are a provider and want to sign up for electronic funds transfer for your DHS CAPS payments, please complete the Direct Deposit Electronic Funds Transfer.


Please complete the Check Loss Affidavit and Agreement if you are a provider and you have lost your check or your check has been lost in the mail.