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Required Package

The Nursing program at Western Iowa Tech Community College require the following services to be performed by Viewpoint Screening:

Background Check:Iowa Statewide Criminal Records (SING)
Iowa Statewide Criminal Records (IA Courts)
County Criminal Records (7 year history, all jurisdictions outside of IA)
Nationwide Crime Database
Iowa Child & Dependent Adult Abuse Registry
Nationwide Sexual Offender Registry
Healthcare Fraud & Abuse Registries
Address History / SSN Validation
Health Portal:This package includes document storage. At the end of the order process, you will have the capability to upload specific documents required by your school for immunization, medical or certification records.
Price:This order is billed to your college.

Do not place this order unless you have been instructed to do so.

Do not place multiple orders under any circumstances.


I have read, understand and agree to the Viewpoint Screening Terms of Use and Refund Policy .

You are placing an order for

NURSING

Click "Confirm" to continue.

If this is not the correct program, go back to the previous page and select the correct package.

Confirm
Upload Release Form
In order to obtain your Iowa Child and Dependent Adult Abuse Registry search, *THIS RELEASE FORM* must be:

FILLED OUT (only fill the highlighted fields)

UPLOADED (upload this form back onto site)

You cannot/will not be able to proceed with your order until this form has been completed and uploaded here.
* The form may be filled out electronically *

If the correct form is not provided or if it is not filled out correctly, the Iowa Child and Dependent Adult Abuse item of your background check will be cancelled and you will be required to place a new Iowa Child and Dependent Adult Abuse order at the cost of $5.00.


Applicant Information
First Name*:  
Last Name*:
Middle Name:
Alias/Maiden Name 1:
Please Note: If you DO NOT have an alias name, leave this field blank. Only provide if you have used an alias within the last 7 years.
Alias/Maiden Name 2:
Please Note: If you DO NOT have an alias name, leave this field blank. Only provide if you have used an alias within the last 7 years.
Alias/Maiden Name 3:
Please Note: If you DO NOT have an alias name, leave this field blank. Only provide if you have used an alias within the last 7 years.
Social Security Number*:
-
-

Please Note: If you have not been issued a valid U.S. SSN then enter all zeros (000-00-0000) instead.
Date of Birth*:
/
/
(mm/dd/yyyy)
Gender*: Male        Female
Phone Number*: (111-111-1111)
E-Mail Address*:

IMPORTANT
Your email address will be your user name to log in. If you have placed a previous order, it is recommended to use the same email address to prevent separate logins. Separate logins will contain separate results / medical documents, and cannot be combined.
 
Type E-mail address.


Re-type E-mail address.

Please make sure you are entering your correct email address. You will be unable to log in or receive communications from Viewpoint Screening if your email address is not valid.
 
Current Residential Address:
Address*:
City*:
State or U.S. Territory*:

For an international address, select "International" and select the foreign Country name below.
Country*:
Zip Code*:
ZIP Code Look Up Tool
Please Note: If you have an international address that does not require a Zip Code, please fill in "00000".
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