Employee Consent Agreement

EMPLOYEE CONSENT AGREEMENT

This Employee Consent Agreement documents the consent and authorizations of the undersigned employee and the conditions under which the Employer may obtain information necessary to evaluate suitability for employment, continued employment, or assignment. Employer Name:

Personal Information

Position Information

Anticipated Start Date:    Salary / Rate: $

Employment History

Most Recent Employer

Dates Employed: From to

Prior Employer

Dates Employed: From to

Education

References

Reference 1

Reference 2

Reference 3

Consent to Background Checks and Verifications

I authorize the Employer, its agents, and third-party service providers to obtain and review consumer reports, investigative consumer reports, background checks, and other information about me for purposes of evaluating my application, continued employment, or assignment. I specifically consent to the following checks (check all that apply):

Criminal background check
Credit report (only where job-related and permitted by law)
Drug and substance screening
Motor vehicle and driving record check
Employment verification
Education and credential verification
Professional license verification

I authorize without reservation any person, firm, current or former employer, institution, government agency, or consumer reporting agency to provide to the Employer such records and information as requested. I further authorize the Employer to share the results of any report or screening with persons involved in the hiring or oversight process, and to use electronic means to store or transmit such results consistent with applicable law.

I understand that any information obtained will be used only for legitimate business purposes and that, to the extent required by law, a pre-adverse action notice and a copy of the consumer report will be provided if the Employer intends to take adverse action based in whole or in part on the report. I understand that I have the right to dispute the accuracy of any consumer report or investigative finding directly with the reporting agency.

Authorization to Contact Previous Employers and References

I expressly authorize the Employer to contact the prior employers, references, educational institutions, and other persons listed in this document for the purpose of verifying the information I have provided and to obtain work-related information including performance, misconduct, and eligibility for rehire. I release all such organizations and individuals from liability for providing such information in good faith.

At-Will Employment and Equal Opportunity

Nothing in this Agreement or in any communication shall be construed to alter the at-will nature of employment, except where a separate written agreement signed by an authorized representative of the Employer provides otherwise. The Employer is an equal opportunity employer and makes employment decisions without regard to race, color, religion, sex, national origin, age, disability, genetic information, or any other protected characteristic under applicable law.

Release, Certification, and Acknowledgement

By signing below, I certify that the information I have provided in this Agreement and in any accompanying application or resume is true, complete, and correct to the best of my knowledge. I understand that falsification, misrepresentation, or omission of material facts may result in denial of employment or immediate dismissal if I am employed. I hereby release the Employer, its officers, agents, employees, and any person or organization providing information from any and all claims, demands, or liabilities arising out of the obtaining or release of information, except to the extent otherwise provided by law.

I understand that this authorization remains in effect for twenty-four (24) months from the date signed below unless I revoke this authorization in writing. I understand that any revocation will not affect actions taken by the Employer prior to receiving the written revocation.

I certify that all information provided in this Employee Consent Agreement and any attachments is true and complete, and I understand that false statements may disqualify me from employment or be grounds for termination.

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