Can this form be signed electronically?

Yes. Under the ESIGN Act (15 U.S.C. ch. 96) and UETA, electronic signatures are legally equivalent to handwritten signatures if intent, consent, attribution, and reliable record retention are met.

Is notarization required?

Generally no for routine evaluation permissions. Some states or specific release types may require notarization; verify for the intended use and jurisdiction before requiring notarization.

How does an employee revoke consent?

Include a clear revocation procedure in the form. A typical approach requires written notice and specifies an effective date for revocation; revocation does not retroactively undo prior lawful disclosures.

What if the employee refuses to sign?

Refusal can limit the employer’s ability to share evaluations externally. Employers should document the refusal and consider alternative lawful bases for necessary disclosures.

How should signed forms be stored?

Store in a secure HR system with restricted access, tamper-evident audit trails, and retention aligned to legal and policy requirements (see retention timeline).

Are there privacy risks to sharing evaluations?

Yes. Improper sharing can trigger privacy claims or regulatory issues—use minimal disclosure principles and restrict recipients to those with a legitimate need.

Electronic Signature
Templates
HR
Employee Evaluation Permission

Employee Evaluation Permission

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

EMPLOYEE EVALUATION PERMISSION

This Employee Evaluation Permission authorizes the employer to conduct workplace performance assessments, to collect evaluation-related information from designated third parties, and to retain and use evaluation records for personnel decisions in accordance with the terms below. The employee's written consent is required for certain contacts and background checks. Completion of this form documents the employee's informed authorization.

Personal Information

Full Legal Name Employee ID (if applicable) Address

Phone

Email

Position Information

Job Title Department Reporting Manager

Employment Start Date: Current Salary (annual):

Employment History

Employer 1 — Company Name

Title / Position

Dates Employed

Primary Responsibilities Reason for Leaving

Employer 2 — Company Name

Title / Position

Dates Employed

Primary Responsibilities Reason for Leaving

Education

Highest Degree or Certification Institution Graduation Date Additional Education or Training

Professional References

Reference 1

Reference 2

Reference 3

Evaluation Scope and Authorization

Evaluation Period: From to .

I authorize the following evaluation activities (check all that apply):

Self-evaluation by employee Manager/supervisor evaluation Peer evaluation Direct report / subordinate evaluation External assessor or consultant evaluation

Consent to Contact and Background Checks

By signing below, I authorize the employer and its designated agents to contact the references and previous employers listed on this form for the purpose of obtaining employment-related information relevant to my evaluation. I further authorize the employer to order consumer reports, criminal history checks, and other background checks where permitted by law, subject to any separate disclosure and consent requirements.

I authorize contact with listed references and prior employers. I authorize pre-employment or continuing background checks as necessary for evaluation purposes.

Privacy, Use and Retention of Evaluation Records

Evaluation records, including completed assessment instruments and third‑party reports, will be retained in the employee's personnel file. Access will be limited to individuals with a legitimate business need. Evaluation content may be used for performance management, training, promotion and disciplinary decisions. The employer will take reasonable steps to safeguard confidential evaluation materials consistent with applicable law.

Legal Disclosures

At-Will Employment: Nothing in this permission form alters the at-will employment relationship, unless a separate written agreement signed by an authorized company representative states otherwise. Either the employer or the employee 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 without regard to race, color, religion, sex, national origin, age, disability, marital status, or other protected characteristics in accordance with applicable law. Evaluation processes will be administered in a manner consistent with these obligations.

Employee Certification and Acknowledgment

I certify that the information I have provided on this form is true, accurate, and complete to the best of my knowledge. I authorize the employer to obtain the evaluation materials, to contact references and prior employers, and to conduct background checks as indicated. I understand that false or misleading statements on this form may result in disciplinary action up to and including termination.

I understand that I may withdraw this consent at any time by providing written notice to Human Resources, but that such withdrawal will not affect any actions taken in reliance on this consent prior to receipt of the withdrawal.

Optional Employee Comment (regarding evaluation scope or references)

Employee Printed Name:

Signature:

Date:

By signing above, I acknowledge that I have read, understand, and consent to the terms of this Employee Evaluation Permission.

What an Employee Evaluation Permission Is and when it’s used

An Employee Evaluation Permission is a written authorization that documents an employee’s consent to employer-conducted performance evaluations, sharing of evaluation results with designated parties, or release of evaluation-related records for specific purposes. Typical uses include internal performance reviews, reference checks, training records, promotion decisions, and limited third-party disclosures. The form clarifies scope, duration, and recipients of evaluation information, and records employee agreement to the evaluation process and any related data handling. Properly completed permissions reduce ambiguity and support compliance with privacy, employment, and record-retention rules.

Why a clear Employee Evaluation Permission matters

A concise permission form protects both employer and employee by documenting consent, limiting scope, and specifying retention. It reduces dispute risk and supports lawful information sharing under U.S. electronic-signature law and sector privacy rules.

Who typically completes and signs this permission

Signatures from the employee and an authorized employer representative are usually required; additional signers may be included for third-party releases.

Human Resources — Prepares the form, manages storage, and documents consent for personnel files.
Employees — Review, sign, and date to acknowledge evaluation scope and sharing permissions.
Hiring or Line Managers — Initiate the evaluation and confirm the authorized recipients of results.

Core elements to include in a professional Employee Evaluation Permission

A complete permission form balances clarity with legal sufficiency: identify parties, define scope, set dates, describe recipients, specify purposes, and include signature blocks with dated consent.

Parties

Full legal names of employer entity and employee, with job title and department.

Scope

Clear description of which evaluations, reports, or records are covered (e.g., annual review, 360 feedback).

Purpose

Explain why the evaluation will be used (promotion, training, reference, disciplinary review).

Recipients

List internal groups and any external third parties permitted to receive results.

Effective Period

Start and end dates for consent or an event-based termination condition.

Signature Block

Employee signature, printed name, date, and employer-authorized signatory with title.

How to complete an Employee Evaluation Permission — step by step

Follow these sequential steps to prepare, confirm, and store the permission correctly.

01

Prepare Form: Populate employer and employee details and define scope.
02

Specify Recipients: List internal and external recipients with purpose.
03

Obtain Consent: Have the employee sign and date the permission.
04

File Record: Store the signed form in the personnel file and retention system.

Typical routing and handling workflow

A standard routing path establishes responsibility and preserves an audit trail during evaluation processing and sharing.

Draft: HR or manager completes the permission form with required fields.
Sign: Employee and authorized employer representative sign (electronic signing acceptable).
Distribute: Provide copies to listed recipients per the permission scope.
Archive: Store the signed permission in HR records with access controls.

Key settings for online completion and e-submission

Configure the digital workflow to capture required data, verify signers, and preserve an admissible audit trail.

Field	Configuration
Signature Field	Required for employee and employer signers
Date Field	Auto-populate or require MM/DD/YYYY entry
Authentication	Email verification or SMS code recommended
Audit Trail	Enable IP, timestamp, and action logs

Technical considerations for secure eCompletion

Ensure the platform provides tamper-evident storage, configurable retention, and compliance features relevant to your industry.

File Formats: PDF and DOCX accepted for fillable templates
Integrations: Common integrations include HRIS, Microsoft 365, and Google Workspace
Authentication: Support for email, SMS, and advanced signer verification

Security and compliance features to verify

In-transit encryption: TLS 1.2/1.3

Data at rest: AES-256 encryption

Audit trail: IP, timestamp, action log

HIPAA readiness: BAA available where required

Regulatory certs: SOC 2 Type II, ISO 27001

Accessibility: WCAG 2.0 Level AA support

Common mistakes to avoid when preparing permissions

Vague recipient lists that permit unintended disclosures.
Missing effective or expiration dates causing unclear consent periods.
Using initials or unchecked boxes instead of a signed consent.
Failing to store the signed form in personnel records securely.

Potential risks and legal consequences of errors

Privacy violation: Civil fines or regulatory action for improper disclosures

HIPAA exposure: HIPAA penalties if health data handled without BAA

Employment disputes: Claims for unauthorized use of evaluation materials

Record admissibility: Unsigned or poorly executed forms may be inadmissible

Discrimination risk: Incomplete documentation can complicate defense against claims

Operational delays: Missing permissions impede promotions or transfers

Timing considerations and expected processing steps

Set clear dates for when consent takes effect and when evaluations will be completed or shared to avoid misunderstandings.

Consent Effective Date:

Enter MM/DD/YYYY; begins the authorization period

Evaluation Window:

Specify start and end dates for the review period

Disclosure Deadline:

Date by which results must be shared with authorized recipients

Record Retention Start:

Date used to calculate retention obligations

Revocation Notice:

Specify how much notice is required to withdraw consent

eSignature vendor comparison — pricing and key limits

This table compares starting prices and basic plan constraints relevant when choosing an eSignature provider for Employee Evaluation Permissions.

	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	7-day free trial	Varies by vendor	Varies by vendor	Varies by vendor	Varies by vendor
Bulk Send	Yes	Yes	Yes	Yes	Varies
Audit Trail	Yes	Yes	Yes	Yes	Yes
Envelope Cap	No cap	100 envelopes/user/year	Varies	Varies	Varies

Practical examples of how organizations use the permission

Real-world examples illustrate common variations and practical choices when deploying the form.

Optica Ventures

HR implements a standard permission form for annual performance reviews

Reduces time collecting consents across distributed teams
Optica stores signed permissions in a centralized HRIS and links evaluation files to personnel records to simplify audits and promotions.

Fertility Centers of Illinois

Healthcare employer adds HIPAA-specific authorization language

Ensures third-party labs receive only permitted evaluation data
The form includes explicit recipient names, retention terms, and a BAA where PHI sharing is involved.

Frequently asked questions about Employee Evaluation Permissions

Answers to common questions about form validity, electronic signatures, revocation, and storage practices.

Need help? Contact support

Can this form be signed electronically?
Yes. Under the ESIGN Act (15 U.S.C. ch. 96) and UETA, electronic signatures are legally equivalent to handwritten signatures if intent, consent, attribution, and reliable record retention are met.
Is notarization required?
Generally no for routine evaluation permissions. Some states or specific release types may require notarization; verify for the intended use and jurisdiction before requiring notarization.
How does an employee revoke consent?
Include a clear revocation procedure in the form. A typical approach requires written notice and specifies an effective date for revocation; revocation does not retroactively undo prior lawful disclosures.
What if the employee refuses to sign?
Refusal can limit the employer’s ability to share evaluations externally. Employers should document the refusal and consider alternative lawful bases for necessary disclosures.
How should signed forms be stored?
Store in a secure HR system with restricted access, tamper-evident audit trails, and retention aligned to legal and policy requirements (see retention timeline).
Are there privacy risks to sharing evaluations?
Yes. Improper sharing can trigger privacy claims or regulatory issues—use minimal disclosure principles and restrict recipients to those with a legitimate need.

be ready to get more

Join over 28 million airSlate SignNow users

Sign Now