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Home Care Agency

FEE: $39.50 – Colorado and Nationwide fingerprint based Criminal History Record Information (CHRI) search Type information or print legibly in BLACK ink.

All fingerprint based CHRI search cards must be filled out completely with the following information in the corresponding fields:

  • Name, Date of Birth, Place of Birth, Sex, Race, Height, Weight, Eyes, Hair (Please use 3 letters abbreviations for eyes and hair – Ex: Brown = Bro, Blue = Blu)
  • CTZ - Fee (Amount listed at the top of the page) must be paid by Money Order or other Certified Funds Check. (Make check payable to Colorado Bureau of Investigation.) Personal checks are not accepted.
  • OCA – CONCJ9200
  • Employer and Address – Colorado Department of Public Health & Environment 4300 Cherry Creek Dr South Denver, CO 80246
  • Contact Information – Laura Bradshaw (303) 692-2800
  • Web Site – http://www.cdphe.state.co.us/hf/homecarelicensure
  • Reason Fingerprinted – Home Care CRS 25-27.5-106


If any of the above information is missing or incomplete, the request will be returned.


CBI / Identification Site