Virginia Child Abuse - Initiation Request

Department of Social Services

Applicant
In order for CastleBranch to initiate the Virginia Child Abuse request through the Virginia Department of
Social Services online web portal, we need you to complete some initial information. Complete the below
fields and upload to the requirement in your myCB To-Do List that you downloaded this from. Within 1-2
business days of receipt CastleBranch will initiate your request and you will receive further instructions on
your next steps.

Complete Required Information

Legal First Name: _______________________________________________________________

Legal Last Name: _______________________________________________________________

Email Address: _________________________________________________________________

**This will be the email address where you will receive your Virginia DSS initiation email to continue the
ordering process. Make sure you enter it accurately to avoid errors/delay in your order.**

Purpose of Search: Select the appropriate reason below that you are submitting this request. (Reach out
to the requesting agency you are placing this order for if you have questions about what to select.)
Adam Walsh Law
Adoptive Parent
Babysitter/Family Day Care
CASA
Children's Residential Facility
Custody Evaluation
Day Care Center
Foster Parent
Institutional Employee
Other Employment
School Personnel
Volunteer
Other (specify): _______________________________________________________________

1844 Sir Tyler Drive, Wilmington, NC 28405 • 888.723.4263 • CastleBranch.com