Background Check

We are Medicare and Medicaid certified and also accept the following:

Aetna
Molina
Private Pay
Passport
MyCareOhio

COMPANY CONTRACT ENROLLMENT

Premier Choice Health LLC is an authorized agency providing electronic fingerprinting and background check services throughout the State of Ohio.

We offer both onsite and mobile fingerprinting for companies and individuals across a wide
range of industries — including law enforcement, home health care, real estate, education, churches, and more.

At Premier Choice Health, we understand that the fingerprinting process can sometimes feel stressful or confusing, even for those familiar with it. That’s why we take pride in offering friendly, personalized customer service.

Our team works closely with every client to ensure you understand each step of the process and have all your questions answered promptly.

Our Commitment to You
Responsive Support: Available by phone, email, or fax during business hours.
Accurate & Reliable: Advanced fingerprinting technology with a rejection rate of less than 1%.
Quality Assurance: We’ll take a second set of prints if needed — at no additional cost.

What Our Clients Are Saying

• “The owner was very accommodating when I called to schedule an appointment. They opened early to fit my
schedule and thoroughly explained the process and turnaround time. Very professional!”
• “Excellent location, flexible appointment times, and outstanding service!”
• “Customer service was five-star — kind, professional, and efficient!”
• “The technician was so patient and personable! I highly recommend them for all your background check needs.”

Company Name *

Company Address *

Address Line 1

Address Line 2

City

State

Zip Code

Company Contact Name

Company Contact Email *

Company Contact Phone *

Background Check Type *

BCI - $40.00
FBI - $40.00
BCI & FBI - $70.00

Select Payment Method *

Credit Card
Pay at the time of appointment
Invoice

Terms of Contract for Invoicing

I agree to the monthly billing terms quoted to me by Premier Choice Health Services, LLC. All invoices are due 45 days after statement date. If not paid in full within 45 days, then a $25 late fee will be applied to the account until the balance is satisfied.

Company's Contact Signature

Date *

Background Check - Registration Form *

BCI Only
FBI Only
BCI & FBI

Request for a Background Check via Electronic Fingerprinting
Please INITIAL next to which type of background check you are being fingerprinted for

Personal Information

Name *

First

Last

Date of Birth *

Social Security Number *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Reason for Background Check (BE SPECIFIC) *

Reason for FBI Check (BE SPECIFIC) *

Address for result to be mailed to: *

Address Line 1

Address Line 2

City

State

Zip Code

RELEASE OF BACKGROUND CHECK RESULTS

I hereby certify that I have given Premier Choice Health Services, LLC permission to obtain all criminal history information pertaining to me in the files of the Ohio Bureau of Criminal Identification and Investigation (BCI&I), Federal Bureau of Investigation (FBI) (if requested), and release that information to the agency/company/individual indicated above.

By placing my finger on the WEBCHECK SCANNER, I am authorizing BCI&I to release criminal history information to Premier Choice Health Services, LLC and the agency/company/individual indicated above.

I hereby release BCI&I and any and all individuals connected therewith from all liability in connection with the dissemination of such criminal history information.

Signature *

Clear Signature

Date *

Terms of Contract for Invoicing

Personal Information

Complete this portion only if an FBI check is needed

RELEASE OF BACKGROUND CHECK RESULTS