Classic form

Background check consent form

Consent that is buried on page four of an application is not really consent. This form stands on its own, lists each check as a separate line the candidate ticks or does not, collects the five years of addresses a police check actually needs, and sets out in plain words what the candidate can ask for afterwards. It is a classic form, because it carries an identity document upload and an inline signature, neither of which works in a conversational one.

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Welcome screen of the background check consent form example — The welcome screen respondents see first. The image was generated for this example.

The form itself

A static copy of the finished form, exactly as it renders. Nothing here can be filled in or submitted, so read it as a reference and build your own from the button above.

Consent to background checks

This is a separate document from your application on purpose. Read it on its own, tick only the checks you agree to, and keep a copy. Nothing is run until this comes back signed, and a check you decline is not run at all.

You are being asked to consent because this role involves working with people who depend on us. Consent has to be specific, informed and given freely, which means you should be able to read what each check does before you agree to it, and refuse one without being told the form cannot be submitted. Refusing a check that the role legally requires may mean we cannot offer you the role, and we will tell you that rather than letting you find out later.

Who you are

Your full legal name *

Title

First

Middle

Last

Date of birth *

Any other name you have been known by *

Email we should use *

Best contact number *

Country of birth

Where you live now *

Street 1

Suburb

State

Postcode

A police check is run against every address you have held for the last five years, so a gap in this table is the single most common reason one comes back unable to proceed. Approximate months are fine; a missing address is not.

Everywhere you have lived in the last five years

#	Address	Suburb and state	From, month and year	To, month and year
1
2
3
4

The checks, one at a time

Each line below is a separate check with a separate purpose. Identity is confirmed against your documents. The police check is run by an accredited provider and returns disclosable court outcomes rather than an opinion. Right to work is verified against the government service. Qualification and employment checks contact the issuing body or the employer you named, and nobody else.

I consent to each of the checks I have ticked *

Confirming my identity from the documents I provide

A nationally coordinated criminal history check

Confirming my right to work in this country

Verifying the qualifications I have listed

Confirming the employment history I have listed with those employers

A working with vulnerable people or children check, where the role requires one

Checking my driving record, where the role involves driving

A check of professional registration where the role requires it

Has a check like this ever been refused or withdrawn? *

Yes, and I have explained below

I do not know

Do you hold a current check we could rely on instead? *

Yes, and the details are below

Yes, but it is for a different state

Anything you would rather we heard from you first

Proof of identity

A nationally coordinated criminal history check needs four identity documents: one that commences your identity, such as a full birth certificate or a current passport, one that shows you use that identity in the community, such as a driver licence, and two more secondary documents, such as a Medicare card or a recent utility account in your name. If the name differs between any of them, add the document that links the two, usually a marriage certificate or a change of name certificate.

Your identity documents *

Click to upload

Max: 10MB

Up to six files, PDF or photo, 10 MB each. Photograph each document flat, in daylight, with all four corners in frame and no flash glare across the details. A cropped corner or a blurred number is the reason most identity checks stall for a week.

What you are entitled to

You can ask for a copy of any result we receive about you. You can dispute anything in it with the body that issued it, and we will pause on that item while you do. A result is assessed against the actual role rather than treated as an automatic bar, and if it changes our decision you will be told and given a chance to respond before anything is final. Results are held with your recruitment file, are not shared outside the people making the decision, and are destroyed on the schedule in our privacy policy.

I have read this section *

I understand what each check I ticked involves

I am giving this consent freely and it is mine to give

I know I can ask for a copy of any result

The information I have given here is true to the best of my knowledge

Sign here

Date signed *

Every field, and what it collects

The complete field list, in the order respondents meet it.

Your full legal nameNameRequired
Date of birthDateRequired
Any other name you have been known byShort textRequired
Email we should useShort textRequired
Best contact numberShort textRequired
Country of birthShort text
Where you live nowAddressRequired
Everywhere you have lived in the last five yearsTable: Columns: Address · Suburb and state · From, month and year · To, month and year
I consent to each of the checks I have tickedMultiple choiceRequired: Options: Confirming my identity from the documents I provide · A nationally coordinated criminal history check · Confirming my right to work in this country · Verifying the qualifications I have listed · Confirming the employment history I have listed with those employers · A working with vulnerable people or children check, where the role requires one · Checking my driving record, where the role involves driving · A check of professional registration where the role requires it
Has a check like this ever been refused or withdrawn?Single choiceRequired: Options: No · Yes, and I have explained below · I do not know
Do you hold a current check we could rely on instead?Single choiceRequired: Options: No · Yes, and the details are below · Yes, but it is for a different state
Anything you would rather we heard from you firstLong text
Your identity documentsFile uploadRequired: Up to six files, PDF or photo, 10 MB each. Photograph each document flat, in daylight, with all four corners in frame and no flash glare across the details. A cropped corner or a blurred number is the reason most identity checks stall for a week.
I have read this sectionMultiple choiceRequired: Options: I understand what each check I ticked involves · I am giving this consent freely and it is mine to give · I know I can ask for a copy of any result · The information I have given here is true to the best of my knowledge
Sign hereSignature
Date signedDateRequired

What makes this form work

The address table is why a police check completes

Four rows of address, suburb, from and to. Checks are run against a five year address history, and the item that most often stalls one is a gap somebody did not think worth mentioning. Asking for it as a table with dates makes the gap visible while the candidate is still in front of the form.

The rights section is written before the result exists

A copy of any result, a route to dispute it, the promise that it is assessed against the role rather than treated as an automatic bar, and a chance to respond before a decision is final. Setting that out at consent time is what turns a checkbox into something a candidate can genuinely agree to.

The upload field teaches people how to photograph a document

Flat, daylight, four corners in frame, no flash across the details. A file upload description is one of only two that a classic form shows the respondent, and using it here removes the week of back and forth that a cropped licence corner otherwise causes.

Questions people ask

Why should the consent be a separate form?

Because consent is only meaningful if the person can see what they are agreeing to. Bundled into an application, it is signed alongside twenty other things and nobody reads it. Some jurisdictions go further and require the disclosure to stand alone in its own document. Separating it also gives you a clean record of exactly what was consented to and when.

Why tick each check individually instead of one box?

One box collects one signature for eight different purposes, and it cannot show which of them the person actually agreed to. Eight lines let a candidate decline a driving record check for a desk role without abandoning the form, and they give you a per check record. The form still has to say plainly that refusing a legally required check may end the process.

Does a required signature field work well here?

The inline signature is the right field, but leave it optional rather than required. A signature marked required paints a red "Signature is required" message the moment the form loads, before anybody has touched anything, which reads as an error on a page that is otherwise about trust. It still prints into the response PDF either way.

What happens to the identity documents that get uploaded?

They are stored with the response and appear in the responses view and in the response PDF, images inline and PDFs merged in. That makes retention a real decision rather than an afterthought: photographs of passports and licences should not sit in a form's responses indefinitely, so delete them once the check has run and say so in your privacy policy.

Build your own in about a minute

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