Reference Checking Consent and Authorization Form
Disclosure
Please read the information on this form carefully and completely.
I have applied for employment with Home Loving Care and have provided information about my previous employment. I authorize Home Loving Care to conduct a reference check with my present and /or previous employer(s). I understand that reference information may include, but not be limited to, verbal and written inquires or information about my employment performance, professional demeanor, rehire potential, dates of employment, and employment history.
My signature below authorizes my former or current employers and references to release information regarding my employment record with their organizations and to provide any additional information that may be necessary for my application for employment with Home Loving Care, whether the information is positive or negative. I knowingly and voluntarily release all former and current employers, references, and Home Loving Care form any and all liability arising from their giving or receiving information about employment history, my academic credentials or qualifications, and my suitability for employment with Home Loving Care.
I further authorize Home Loving Care to obtain feedback and references from my supervisors over the course of my employment with Home Loving Care. I understand that subsequent and continued employment with Home Loving Care may be subject to this feedback.
This form may be photocopied or reproduced as a facsimile, and these copies will be as effective as a release or consent as the original which I sign.