Application for criminal history screening (exemption notice) (Form 10-11)

Purpose

For use by a Department of Communities, Child Safety and Disability Services funded non-government service provider or a National Disability Insurance Scheme (NDIS) non-government service provider on behalf of a blue card holder engaged or seeking to be engaged by the service provider.

Checklist

  1. Check that your details are correct
  2. Complete the declaration
  3. Ensure all signatures are on the form

Submitting your request

Mail: Department of Communities, Child Safety and Disability Services
PO Box 10179, Adelaide Street Brisbane QLD 4000
Email: criminalhistoryscreening@disability.qld.gov.au 

Further information

If you have any questions please email Criminal History Screening or phone the criminal history screening hotline: 1800 183 690

If you have any questions please email Criminal History Screening or phone the criminal history screening hotline: 1800 183 690.

Is your feedback

Please submit your comments on the department's Compliments and Complaints section.

Please submit your comments on the Queensland Government website Contacts form.