Employment and HRForm
Background check authorization form template
Ask a candidate's permission before screening them: which checks, which provider runs them, why, how long the results are kept, and how to see or dispute what is found. The candidate signs on their phone.
Opens in the Salsox editor with 6 signing fields already placed for Candidate and Employer. Add their emails and send. The free plan sends 3 documents a month.
Who signs
- Candidate
- Employer (you)
Preview
Background Check Authorisation
Employer: Brookfield Care Homes Ltd Candidate: Emily Davies Role: Senior Care Assistant
1. What will be checked
With your permission, the following checks will be carried out: identity and right to work; an enhanced criminal record check including the barred list for adults; two employment references covering the last three years; and verification of the NVQ Level 3 in Health and Social Care.
2. Who carries them out
The checks will be carried out by VerityCheck Screening Ltd, 10 Fleet Place, London EC4M 7RB on the employer's behalf. They will contact only the sources needed for the checks above.
3. Why
These checks are needed because the role involves unsupervised care of vulnerable adults, and the law requires these checks for it. The results will be used only to decide on your application for this role.
4. Your information
The employer will keep the results securely for six months after the hiring decision, unless the candidate is hired, when relevant results are kept on the personnel file, then delete them. They will be seen only by people involved in the hiring decision.
5. Your rights
- You may ask for a copy of the results by writing to privacy@brookfieldcare.example.
- If anything found might affect the decision, you will be told and given the chance to explain or correct it before the decision is made.
- You may withdraw this authorisation before the checks are completed, by writing to the same address.
6. Previous names and addresses
For the checks above, I have provided my previous names and addresses for the last five years, if any: Answer · Candidate
7. Authorisation
I authorise the employer and the screening provider to carry out the checks described above, and I confirm that the information I have provided in my application is true and complete.
Signatures
Candidate: Signature · Candidate Date: Date · Candidate Name: Name · Candidate
Received for the employer: Signature · Employer Date: Date · Employer
These templates are general starting points, not legal advice. Laws differ between countries and states: check that a template suits your situation, or ask a lawyer, before you rely on it.
About the Background check authorization form template
Background checks are routine for many roles, but they involve sensitive information, and most laws require the candidate's informed consent first. The candidate should know which checks will be run, by whom, why they are needed for this role, how long the results will be kept, and how they can see and correct what is found.
This template sets that out in plain words and records the candidate's authorisation. It keeps the checks proportionate by tying them to the role, states that results are used only for the hiring decision, and explains the candidate's right to see the results and to respond before any decision is made on them.
Rules differ widely. In the United States, consumer report checks need a stand-alone disclosure under federal law and some states add their own forms; in the UK, criminal record checks depend on the role's eligibility; across Europe, the GDPR limits criminal data processing. Adapt the wording, and the list of checks, to the law where the candidate is hired.
- Signers
- 2
- Signing fields placed
- 6
- Details to fill in
- 8
How to use this template
Open it in Salsox
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The editor already has every signature, date and initials field in place. Add each signer's email and send; they sign on their phone, and everyone gets the sealed copy with its audit trail.
Used in
Questions
Can a candidate refuse a background check?
Yes. Consent is their choice, but if the check is a lawful requirement of the role, the employer may not be able to continue with the application without it.
Will the candidate see the results?
Under this form, yes, on request, and before any decision is taken because of them, so they can explain or correct anything that is wrong.
Is a separate disclosure needed in the United States?
For checks that count as consumer reports, federal law requires a clear disclosure in a document of its own. Use this form as the authorisation alongside that disclosure, and check state requirements.
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