I have read the 3CareU4's Policy and Procedures on Caregiver Background Checks and authorize the agency where I am applying to make the following background checks during the application/screening process and during the course of my employment: criminal background check, caregiver misconduct check, and registry checks as required by Wisconsin Administrative Code Chapter 12 and Chapter 13. Furthermore, the information received in connection with these background checks is strictly confidential and will not be released except to the personnel specified in the 3Care4U's Policy and Procedures on Caregiver Background Checks.

Unless I so authorize in writing, 3Care4U will not disclose or distribute the information generated from the background checks listed above. Law enforcement, juridical, and government agencies are authorized to release all information about me in connection with the above-authorized background checks. To the extent permitted by law, I release all individuals, companies, corporations, and agencies from all liability, claims, and/or damages related to the above-authorized background checks.