Mississippi State Department of Health – SAFER (Mississippi Screening Assurance for Employee Enrollment and Registries) Criminal History Record Check Unit fax number

Fax destination details

Department

Mississippi Department of Health (CHRC/SAFER)

Purpose

SAFER background check submission for MSDH-licensed facilities; fingerprinting appointment; submission of fingerprint cards or remote transmissions; results and determinations returned to approved facilities.

Form

Fingerprint Authorization Form — SAFER Criminal History Fingerprint Check

Address

143B LeFleur’s Square, Jackson, MS 39211

Voice phone

601-364-1102

Website

Visit organization website

Before you send

• Confirm that this exact department handles your document or request.
• Check the organization website or call its main line for the current fax number.
• Include a cover sheet and any case, member, claim, or form reference required.
• Keep the delivery confirmation with your submission records.

Complete the SAFER application, upload the Fingerprint Authorization Form and Privacy Rights Statement, pay the $50 fee, schedule fingerprinting, and mail the completed fingerprint card to MSDH CHRC Unit (143B LeFleur’s Square, Jackson, MS 39211) if needed. For help, contact CHRC Unit at 601-364-1102 or CHRCUnit@msdh.ms.gov.

Official form instructions are published as a downloadable file on the organization's website.