ID/All Counties within last 7 years; Statewide (Up to 3); Corr, OIG/EPLS, Sex Off-Nation, Federal
E/V's and Malpractice- Up to 2 
Refs- Up to 3 included in package 
FOR TRIAGE: CHECK ALL COUNTIES EVER LIVED IN AND ALL STATES EVER LICENSED IN. TELL ORDER ENTRY TO PUT IN THE BILLING NOTES ALL COUNTIES ABOVE 7 YEARS ANS ALL STATE CHECKS ABOVE 3
NO ACA AND NO LICENSE