TX HHS Form 1725. Criminal Conviction History and Registry Checks

The Texas Health and Human Services (HHS) Form 1725, "Criminal Conviction History and Registry Checks," is used to assess the criminal history and registry status of applicants seeking employment as service providers in the Consumer Directed Services (CDS) option. This form is essential for ensuring that individuals hired through this program meet the necessary qualifications and do not pose a risk to patients or clients.

This form requires applicants to provide their authorization and acknowledgment for criminal conviction history checks, registry verification, and exclusion list screenings. Employers must also complete sections of the form, including certification of agreement for criminal conviction history checks and registry verification processes. The form highlights the importance of confidentiality and destruction of sensitive information, emphasizing the need for secure methods in sharing and storing criminal records.

The Form 1725 is a critical tool for Texas HHS to ensure that service providers meet the necessary qualifications and do not pose a risk to patients or clients. By using this form, employers can verify an applicant's criminal history, registry status, and exclusion list screenings, ultimately ensuring the safety and well-being of those receiving services through the CDS option.