DBS Consent Form | Lamora Healthcare Staff

Fields marked * are required. All submissions are processed securely and in accordance with our Privacy Policy.

Personal Details

Legal First Name(s) *

Legal Surname *

Any Previous Names Used

Date of Birth *

Place of Birth *

National Insurance Number *

How long at current address?

Current Address *

Previous Address (if at current address less than 5 years)

Identity Document

Primary Identity Document *

Document Expiry Date

You will be required to present original identity documents in person. Lamora Healthcare will not submit a DBS application without verifying original documents.

Declaration

Do you have any unprotected convictions, cautions, reprimands, or warnings? *

Type your full name as a digital signature * Typing your name confirms your consent to the DBS check.

I consent to Lamora Healthcare Ltd submitting an Enhanced DBS application on my behalf for regulated activity with vulnerable adults and/or children. I confirm all information is accurate and complete. I understand providing false information is a criminal offence. I consent to processing in accordance with their Privacy Policy.

✓ Your DBS consent form has been submitted. We will be in touch to arrange verification of your original identity documents.