Adult Maltreatment Registry Check

All ASN employees must complete the adult maltreatment registry check (sometimes called adult background check) every 2 years. This is done through an online form: CLICK HERE

Note: If the form is filled out incorrectly, we will have to have you redo it.

  1. Click Start
  2. Fill out your information
  3. Select the number of addresses you need to cover the past 5 years
  4. Enter your addresses. Make sure you include the entire address including city, state, and zip code. Do not include P.O. boxes
  5. Under “Agency Name/Contact Person” enter Arkansas Support Network
  6. Under “Agency Type” enter Non-Profit (no charge)
  7. The mailing address is 6836 Isaac's Orchard Road, Springdale, AR 72762
  8. Under “Agency Email” enter asnhrdepartment@supports.org
  9. Click “Click here to have form sent to your email.” (You will receive an email asking you to sign the form.)
  10. Follow the link in the email and sign the document. (You will receive a second email with a copy of your signed form.)
  11. Forward the signed form to asnhrdepartment@supports.org or upload it using the "Submit Ticket" button at the top right of this page.