Background verification consent form

A background verification consent form is a document that is used by employers to obtain an individual's permission to conduct a background check. This form usually includes information about the individual's rights, the types of background checks that may be conducted, and the purpose of the background check.

3 minutes to complete


The background verification consent form can be filled by any individual who wishes to conduct a background check on another individual.


Questions for Background verification consent form



Full Name

The answer should be a text input.

Date of Birth

The answer should be a date input.

Social Security number

The answer should be a number input.

Current residential address

The answer should be a text input.

Phone number

The answer should be a phone number.

Email address

The answer should be an email input.

Current employment status

The answer should be a multiple choice:
  1. Employed
  2. Unemployed
  3. Servicing Notice

How many years of professional work experience do you have?

The answer should be a number input.

Please list all previous employers, including contact information.

The answer should be a text input.

Have you ever been convicted of a crime?

The answer should be a single choice:
  1. Yes
  2. No

If yes, please explain the circumstances.

The answer should be a text input.

Please list any relevant professional licenses or certifications.

The answer should be a text input.

Do you have any professional references? if yes please provide contact information.

The answer should be a text input.

I hereby give consent for my employer to conduct a background verification on me. I understand that this may include, but is not limited to, verification of my employment history, education, and criminal background. I release all parties from any liability that may result from the use or misuse of this information.

The answer should be a single choice:
  1. I Agree
  2. I Disagree


The answer should be a signature.


The answer should be a date input.

Please upload the documents required

File needs to be uploaded.

Forms Similar to Background verification consent form

  • Employment history verification form
  • Education verification form
  • Criminal background check consent form
  • Reference check consent form
  • Credit check consent form
  • Motor vehicle records check consent form

Here are some FAQs and additional information
Background verification consent form

What is the purpose of background verification consent form?

A background check cannot be conducted without the applicant's consent. If the company decides not to hire the job applicant, the employer must explain why. An applicant also receives a copy of the background check report and has the option of contesting it.

What if I change my mind after I have submitted my consent form?

If you change your mind after submitting your consent form, you can contact the potential employer and request that your form be withdrawn.

What happens if I do not consent to the background check?

If you do not consent to the background check, the potential employer may choose not to hire you.

How long does the background verification process take?

The entire process generally takes 2-3 weeks from start to finish.

How will I know if there is a problem with my background check?

You will be contacted by a member of the HR team if there are any concerns with your background check.

What things appear on a background check?

Criminal background checks will reveal felony and misdemeanor criminal convictions, any pending criminal cases, and any history of incarceration as an adult.

Want to use this template?

Loved by people at home
and at work

“BlockSurvey is a simple, effective, and scalable tool for creating surveys for leadership and learning assessment. It's one of this year's best buying choices. Each month, it keeps improving and strives to serve its customers needs.”
Nelson Emilio
Personal Branding Strategist
“I use BlockSurvey to get feedback about all my activities and events. It is really easy to get started and create my first surveys! Then I could see how easy it was to share them. Now I am thinking to use BlockSurvey also within my creative process as an author in order to listen and engage with my audience, knowing that anonymity provides the most sincere and reliable answers.”
Georgina García-Mauriño
Author & Designer
BlockSurvey social proof
G2 Crowd
4.8 Star Rating
BlockSurvey social proof
Editor's choice
BlockSurvey social proof
4.9 Star Rating

What's next? Try out templates like
Background verification consent form

1000+ Templates, 50+ Categories

Want to create secure online forms and surveys?

Join BlockSurvey.