Establishing secure connection…Loading editor…Preparing document…

Employee CHRC Form

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

Employee CHRC Form

Personal Information

Position Information

Full-time    Part-time    Contract    Internship/Temporary

Criminal History Record Check (CHRC) — Disclosure & Consent

As a condition of employment or continued employment, the employer requires a Criminal History Record Check (CHRC). This check may include a review of national, state, and local criminal records, sex offender registries, and driving records where job-related. By signing below, I authorize the employer and its designated agents to obtain criminal history information about me for employment purposes, to the extent permitted by law.

I consent to the collection of biometric identifiers, including fingerprinting, where required for the CHRC process, and I authorize the release of any such records to the employer. I understand that the employer will use this information only for screening and employment-related decisions and will handle the information in accordance with applicable privacy laws.

I authorize background checks and release from liability any person, agency, or entity that provides information in response to inquiries made by the employer in connection with my application, including criminal history checks and verification of prior employment, education, and professional credentials.

I authorize the CHRC and related background screenings described above.    I consent to fingerprinting if required.

Have you ever been convicted of, or pleaded guilty or nolo contendere to, a felony or misdemeanor? Please exclude convictions that have been sealed, expunged, or statutorily eradicated where the law permits disclosure to employers.

Yes    No

Employment History — Most Recent Employers

Education

References

Legal Disclosures

At-Will Employment: Employment with the employer is at-will, unless otherwise provided in a written agreement signed by an authorized representative of the employer. Either the employee or the employer may terminate the employment relationship at any time, with or without cause and with or without notice.

Equal Opportunity: The employer provides equal employment opportunity to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, veteran status, or any other characteristic protected by applicable law.

Authorization to Contact: I authorize the employer to contact previous employers, educational institutions, licensing authorities, and references to verify the information provided and to obtain additional information relevant to my application or employment.

I authorize the employer to contact prior employers, educational institutions, and references as necessary for screening and verification purposes.

Applicant Certification

I certify that all information provided on this form and in any attachments is true, accurate, and complete to the best of my knowledge. I understand that falsification, omission, or misrepresentation of information may result in denial of employment or immediate termination, if employed. I further acknowledge that information obtained through the CHRC and other background investigations may be used in making employment decisions.

I hereby release the employer, its agents, and any person or entity providing information from any liability for damages that may result from furnishing information to the employer. I understand that I may be required to provide additional personal identifiers (for example, fingerprints) to facilitate the CHRC process, and I agree to cooperate in providing such identifiers if requested.

Applicant Name:

Signature:

Date:

Enter text✕

What the Employee CHRC Form Is and when it applies

The Employee CHRC Form (Criminal History Record Check consent) documents an applicant or employee's informed agreement to a background screening. It captures identifying details, consent language, and authorization for a consumer reporting agency or employer to obtain criminal history records. Employers use it to comply with the Fair Credit Reporting Act (FCRA) and state screening laws, to verify suitability for safety‑sensitive roles, and to maintain a defensible audit trail of consent and disclosures in recruitment and onboarding workflows.

Why a clear Employee CHRC Form matters

A properly completed CHRC Form documents legally required consent and helps meet FCRA obligations and ESIGN/UETA standards for electronic records. Clear authorizations reduce legal risk, speed hiring decisions, and create an auditable record for compliance reviews.

Why a clear Employee CHRC Form matters

Typical organizations and roles that use the form

Employers, HR teams, staffing agencies, and security-screening vendors routinely request a signed Employee CHRC Form before or after job offers.

  • Human resources teams conducting pre-employment screening and onboarding
  • Staffing agencies and background check vendors coordinating consumer reports
  • Hiring managers and compliance officers documenting FCRA-consistent consent

The form is useful across industries where background checks are standard practice, and it supports both paper and electronic collection methods.

Core components to include in a professional CHRC Form

A well-designed CHRC Form balances clarity and completeness: capture identity details, explicit consent, scope of the check, disclosure language, data retention, and signature elements appropriate for your jurisdiction.

Identification

Full legal name, date of birth, current and prior addresses, and any aliases to ensure accurate matching against criminal records.

Scope

Specify the types of checks (local, state, national, sex offender registry) and the time window or jurisdictions searched.

Disclosure

Include clear FCRA-compliant disclosure and standalone authorization language when a consumer report will be obtained.

Consent

Explicit statement that the applicant/employee authorizes the employer or third party to access criminal history records and related information.

Signature block

A signer name, signature, printed name, and date field; indicate whether electronic signatures are acceptable under ESIGN/UETA.

Retention info

State how long records and screening results will be retained and the internal contact for data correction requests.

Step-by-step: completing the Employee CHRC Form

Follow these ordered steps to collect valid consent and minimize screening delays.

  • 01
    Prepare the form: Include disclosure, authorization, and contact fields.
  • 02
    Collect identity data: Capture full name, DOB, address, and SSN if required.
  • 03
    Obtain explicit consent: Ensure the signer checks consent box and dates signature.
  • 04
    Store audit trail: Save signed copy and retention metadata for compliance.

Typical CHRC workflow from request to result

A standard CHRC workflow involves form issuance, signer authentication, screening, and secure result delivery with an audit trail.

  • Issue form: Employer or vendor sends consent form to candidate.
  • Authenticate signer: Verify identity via email, SMS code, or ID.
  • Run screening: Background vendor queries relevant databases.
  • Deliver results: Employer receives report and documents the outcome.

Configuring an online CHRC form workflow

Set up fields, authentication, and routing to ensure secure, compliant processing of consent and screening requests.

Field Configuration
Identity fields Full name, DOB, address, SSN optional
Consent text FCRA disclosure + clear authorization
Authentication Email link, SMS code, or KBA if required
Routing Send signed consent to background vendor

Platform and technical considerations for electronic CHRC forms

Choose a platform that supports secure eSignatures, strong authentication, and a retrievable audit trail.

  • Document formats: PDF, DOCX support required
  • Authentication options: Email, SMS, or KBA
  • Integrations: HRIS and vendor APIs

Ensure the platform supports compliance standards relevant to screening and allows secure storage and export of signed records.

Typical timelines and processing expectations

Understand expected turnarounds so candidates and hiring teams have realistic timelines for decisions and follow-up.

Request timing:

Request consent pre- or post-offer as policy dictates

Vendor processing:

Background checks commonly complete in 2–14 business days

Adverse action window:

Allow time for pre-adverse notice and dispute handling

Record retention:

Retain consent and report per legal requirements

Correction timeframe:

Candidates may dispute results; vendor response varies

Key milestones in the CHRC lifecycle

Track these numbered stages from issuance through final disposition to maintain compliance and timelines.

01

1. Issue Consent

Send disclosure and authorization to candidate immediately.

02

2. Confirm Identity

Authenticate signer before running checks.

03

3. Receive Report

Vendor returns screening results for review.

04

4. Take Action

Follow FCRA adverse action steps if needed.

Common mistakes that delay or invalidate screening

  • Incomplete identity data or missing aliases cause false negatives or long vendor follow-ups, delaying hiring decisions by days.
  • Using ambiguous or combined disclosure/authorization text can fail to meet FCRA requirements and expose the employer to dispute risk.
  • Accepting unsigned or improperly dated consent undermines defensibility; an auditable signature and timestamp are essential for compliance.
  • Storing signed forms in unsecured locations or without an audit trail increases data breach risk and may violate state privacy laws.

Consequences of improper CHRC handling

FCRA liability: Civil damages and fees
Discrimination risk: Liability under EEOC rules
Regulatory fines: State penalties for noncompliance
Hiring errors: Reputational and operational costs
Data breach: Notification and mitigation expenses
Delay impact: Lost candidates and hiring costs

Security and compliance features to expect

Encryption: TLS 1.2/1.3 and AES-256 at rest
Audit trail: Timestamped actions and IP logs
Standards: ESIGN, UETA compliance
Certifications: SOC 2 Type II; ISO 27001
HIPAA support: BAA available where required
Access controls: Role-based permissions and SSO

Quick vendor pricing and capability snapshot for CHRC eSignature workflows

Compare starting price and key capabilities; signNow is listed first. Confirm vendor terms and HIPAA/BAA availability for sensitive screening workflows.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial Yes, 7-day trial Varies Varies Varies Varies
Bulk Send Yes Yes Yes Yes Varies
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes (BAA) Yes (BAA) Yes (BAA) No No

Real-world examples of electronic CHRC collection

Two concise examples show how organizations use electronic consent and signing to streamline screening and maintain compliance.

Optica Ventures — COO

Optica adopted electronic consent to shorten onboarding time

  • Reduced manual follow-up by centralizing signed records
  • The interface made it easier for candidates and staff to complete background checks promptly and accurately, improving turnaround without compromising compliance.

Fertility Centers of Illinois — Founder

A healthcare provider switched to digital forms for patient and staff screening

  • Implemented a BAA and secure audit trails
  • This allowed consistent documentation, supported HIPAA obligations, and reduced paper handling while keeping records retrievable for audits.

Frequently asked questions about the Employee CHRC Form

Answers to common operational and legal questions about completing, signing, and storing CHRC consent forms.


Need help? Contact support

be ready to get more
Join over 28 million airSlate SignNow users