Download Criminal Background Check PDF Form or fill out the form below

    I understand that a criminal background check is a requiremnet for being considered for employment or volunteering with Galaxy Home Care.
    I consent to Galaxy Home Care causing a criminal background check to be run on me by the Colorado Bureau of Investigation(CBI) and/or the Federal Bureau of Investigation(FBI).
    I hereby fully release and discharege Galaxy Home Care and its officers, agents, ang employees from any and all claims for damages which may arise from participating in or as a result of the criminal background check.
    I understand that Galaxy Home Care will keep this form on file in my personel record for a minimum of two (2) years.
    List any other names or aliases by which you have been known:
    Gender
    MameFemale
    I had read and fully understand this release form.