A background check consent form is the document a candidate signs to authorise an employer or its screening partner to verify specific information, such as employment history or qualifications, before or after a conditional offer. Employers use it to record informed consent, define the scope of checks, and show candidates how their data will be handled.
Ask a candidate to sign this before you or a third-party provider run any background check, so their agreement is on record and they understand exactly what will be checked. What checks are permitted, and what you must disclose beforehand, differs sharply by country and by state, so confirm the rules for your location before you rely on this form.
Candidate name: [CANDIDATE NAME]
Position applied for: [JOB TITLE]
Date of birth (if required for verification): [DATE OF BIRTH]
Contact details: [EMAIL / PHONE]
I, [CANDIDATE NAME], authorise [COMPANY NAME] and, where applicable, its screening partner [SCREENING PARTNER NAME], to conduct the background checks described below in connection with my application for [JOB TITLE].
I understand this authorisation is given voluntarily and that I may ask questions about the process before signing.
I confirm the information I have provided in my application is accurate to the best of my knowledge.
This authorisation applies only to the checks listed in the section below.
The checks covered by this consent are:
[EMPLOYMENT HISTORY VERIFICATION]
[EDUCATION / QUALIFICATION VERIFICATION]
[IDENTITY VERIFICATION]
[CRIMINAL RECORD CHECK, WHERE PERMITTED BY LOCAL LAW]
[REFERENCE CHECKS]
[OTHER - SPECIFY]
No checks outside this list will be carried out without further consent.
Information gathered will be used only to assess my suitability for the role and will be shared only with [NAMES/ROLES OF PEOPLE WHO WILL SEE IT].
Results will be stored for [RETENTION PERIOD] and then deleted or anonymised in line with [COMPANY NAME]'s data retention practice.
I may request details of what was found, subject to the limits that apply under local data protection rules.
Data will not be shared outside [COMPANY NAME] or its named screening partner without my further consent.
If a check raises a concern, [COMPANY NAME] will give me an opportunity to respond before any final decision is made, where required to do so.
I understand I may withdraw this consent at any time by notifying [CONTACT NAME], though this may affect my candidacy for roles where a check is a condition of employment.
Signature: ______________________ Date: ____________
Print name: [CANDIDATE NAME]
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