[PDF] Requirements for Clinical Sites – Forms and Clearances

ACT 34 – PENNSYLVANIA ACCESS TO CRIMINAL HISTORY

ACT 34 – Pennsylvania Access to Criminal History (PATCH). The cost of this clearance is $8.00 and must be paid by credit card through the online application 

1. PA CRIMINAL HISTORY CLEARANCE (Act 34): Find the form at

act 34 pa criminal background clearance

4) Reason for request - check Employment (first block). Submit the completed application along with a $10.00 Certified Check or Money Order

ACT 34 – PENNSYLVANIA ACCESS TO CRIMINAL HISTORY

record for retrieving the clearance and should be stored in your personal records. **Important Notice: The ACT 34 PATCH certification form MUST be printed 

ACT 151 Pennsylvania Child Abuse History Clearance

To complete the online PA Child Abuse History Clearance you will need to have internet access printer

Requirements for Clinical Sites – Forms and Clearances

The basic requirements for all undergraduate students are: Student Uniform. Health form. Clearances (ACT 33/34/73). HIPAA Certificate. CPR Card.

ACT 33 – PENNSYLVANIA CHILD ABUSE CLEARANCE

ACT 33- PA Child Abuse Clearance Application Instructions. The cost of this clearance is $8.00 and must be paid via credit or debit card through the online 

ACT 34 PA State Police Criminal History Record

ACT 34. PA State Police Criminal History Record Reason for Clearance: Employment ... and then click on Certification Form. 8. Print your credential.

Mandatory Clearances through the State of PA

PENNSYLVANIA STATE CRIMINAL BACKGROUND CHECK FOR EMPLOYMENT/ACT 34 ($8.00 fee) https://epatch.state.pa.us/Home.jsp. • Select “Submit a New record Check 

Required Hiring Information Act 34-PA Criminal Record History

There are mandatory clearances/forms that must be obtained prior to working Volunteers are also required to get clearances (Act 34 Act 151