DBS enquiry form

The purpose of this form is for legal support to be arranged for RCN members who have been contacted by the DBS (DS in Scotland, AccessNI in Northern Ireland).

Note that for us to provide legal representation, you must have been in the correct category of membership at the time of the incident cited by the DBS.

If you have been contacted by the DBS, want to challenge the information contained in your enhanced criminal record certificate (ECRC), or have a question about the DBS, please complete the below form.

If you have not been contacted by the DBS but believe you have been referred, we will not be able to arrange support until you have been formally notified, so please don't complete this form yet. Please get back in touch when the DBS has contacted you.

Contact details

Full name: RCN membership number: Address: Best contact number:

Please note that RCN Direct will not usually call you. Where an onward referral is required, provided you were in the correct category of membership at the time of the incident, we will provide these contact details to the RCN’s Legal Department.

Do you give us your consent to pass on this information? Yes No Can we leave you a voicemail? Yes No Can we contact you on this matter by email? Yes No If we need to pass your enquiry to your local RCN office or a specialist RCN department, would you like any emails from them to be password protected? Yes No Email address you would like us to reply to Please confirm the email address you would like us to reply to Please list any times that you are unavailable for calls during the next week (9am-5pm):

Employment details

Place of work Employer When did you start working with your current employer? Ward or department Job category Job title Weekly contracted hours Do you have any meetings scheduled? Yes No If yes, please give date, time and location: Are you already being supported by a rep? Yes No If yes, please include details below: Are you in the UK on a visa? Yes No If yes, please include details below (including how long you have been in the UK):

DBS referral

Have you been contacted by the DBS regarding a referral? Yes No If yes, what is the status of the referral? Date of incident that led to the referral to DBS What date did the DBS contact you? DBS officer name: DBS case reference number: Is there a deadline to respond to the DBS? Yes No If yes, when is the deadline? Please include a brief description of why you have been referred to the DBS, as stated on the DBS letter: Is your employer aware that you have been contacted by the DBS? Yes No Is your employer taking any action against you following the DBS referral? Yes No If yes, please provide brief details

ECRC issue

Do you have an issue with an entry on your enhanced criminal record certificate (ECRC)? Yes No If yes, what is the status of your challenge? Is there a deadline? If yes, please specify date: What ECRC information is disputed? Date of ECRC:

By submitting this form, you are giving the RCN permission to contact you about your submission.

You can control the information you receive from the RCN by updating your preferences at MyRCN.

We don’t update your contact details unless you ask us to. The best way to check and update the details we hold for you is by visiting MyRCN.

Protecting your privacy is very important to us. Please view our privacy policy to find out more about the information we collect and how it is used.

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