Department of Communities, Disability Services and Seniors

Forms

Please note: From 1 July 2018, yellow card system fees will increase 3.5 percent as per the annual indexation rate for fees and charges. 

The Disability Services Act 2006 outlines the criminal history screening requirements for people engaged by a Department of Communities, Disability Services and Seniors funded non-government service provider or a National Disability Insurance Scheme (NDIS) non-government service provider.

In order to carry out the screening process, the department will collect information through a range of forms.

The Disability Services Act 2006 outlines the use of approved forms for the collection of information to be used for a number of different purposes related to criminal history screening.

For further information in relation to forms for particular employment types, please refer to the Information Sheet: Screening scenarios for persons engaged in disability services (PDF, 345 KB) Information Sheet: Screening scenarios for persons engaged in disability services (DOC, 515 KB)

Alternatively, please email Criminal History Screening or phone the criminal history screening hotline on 1800 183 690.

The following forms are for use by a department funded non-government service provider or a NDIS non-government service provider making application on behalf of the person, engaged or seeking to be engaged.

Sole traders are required to undergo criminal history screening to deliver prescribed disability services to NDIS participants.

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

Use this form if the person, engaged or seeking to be engaged, holds a Blue Card which is valid for 3 months or more.

Please note the: the prescribed fee is not payable.

Application for criminal history screening - prescribed notice (yellow card) (Form 10-1)

Use this form if seeking a Yellow card for the person, engaged or seeking to be engaged.

Please note: the prescribed fee is payable.

For sole traders - Application for criminal history screening prescribed notice (yellow card) (Form 10-1ST)

This form is for sole traders proposing to start or continue to deliver services for people with disability under the Disability Services Act 2006 section 52.

Please note: the prescribed fee is payable.

For sole traders - Application for criminal history screening (exemption notice) (Form 10-11ST)

This form is for sole traders, who hold a Blue Card which is valid for 3 months or more, proposing to start or continue to deliver services for people with disability under the Disability Services Act 2006 section 52.

Please note the: the prescribed fee is not payable.

Application for information from register of engaged persons (Form 10-6)

Use this form if requesting information about the current status of an application for criminal history screening or any positive notice, positive exemption notice, negative notice or negative exemption notice issued.

The following forms are for use by a person engaged or seeking to be engaged by a department funded non-government service provider or a NDIS non-government service provider.

Application for eligibility declaration (Form 10-10)

Use this form if you are a disqualified person seeking to be declared eligible to apply for a Yellow Card.

The Disability Services Act 2006 identifies some disqualifying offences, which automatically preclude a person from being issued with a positive notice. If a conviction for one of the disqualifying offences appears in a person's criminal history, or if the person is subject to certain offender reporting or prohibition orders, the person is known as a disqualified person. It is an offence for a disqualified person to apply for a prescribed notice. Please see the fact sheet Who is a disqualified person (PDF, 542 KB) (PDF) Who is a disqualified person (PDF, 542 KB) (DOC, 814 KB) Who is a disqualified person (DOC, 814 KB) (DOC) Who is a disqualified person (DOC, 814 KB) (PDF, 542 KB) for further information, including a complete list of disqualifying offences.

Application for criminal history screening change of details (Form 10-2)

Use this form if your name or contact details change or your engagement with the service provider ends before a decision is reached on your application for criminal history screening.

Change of details of positive notice/card or positive exemption notice/card holder (Form 10-4)

Use this form if you hold a Yellow Card or Yellow Card Exemption and you change your name, start to use a different name or change your contact details.

Application for replacement of lost or stolen positive notice and card or positive exemption notice and card (Form 10-3)

Use this form if your Yellow Card/Yellow Card Exemption and/or the letter advising of your approval to hold a Card (positive notice) has been lost or stolen.

Application for cancellation of negative notice or negative exemption notice (Form 10-5)

Use this form if you are seeking to have a negative notice or negative exemption notice cancelled. (Disability Services Act 2006 Section 82).