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


For use by a person engaged or seeking to be 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 if their name or contact details change or their engagement with that service provider ends before a decision is reached on their application for criminal history screening.


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

Submitting your request

Further information

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