Background Check Disclosure & Authorization

Background Check Disclosure & Authorization
SECTION 1 — DISCLOSURE

Disclosure Regarding Background Investigation

Great Lakes Home Care may obtain consumer reports and/or investigative consumer reports about you for employment purposes. These reports may include information concerning your criminal history, driving record (if applicable), and other public records information as permitted by federal and state law.

Such reports will be obtained solely for employment evaluation and, if applicable, ongoing engagement purposes.

SECTION 2 — AUTHORIZATION

Authorization and Consent

By signing below, I hereby authorize Great Lakes Home Care and its designated agents to obtain consumer reports and/or investigative consumer reports about me for employment-related purposes.

I understand that this authorization shall remain valid during the hiring process and, if engaged, throughout the term of my service with the agency as permitted by law.

I acknowledge that I have received this disclosure as a separate document and that I provide my consent voluntarily.
I have read and understand the above disclosure and authorize Great Lakes Home Care to conduct a background investigation for employment purposes.ption 1
Name*

First NameLast Name
Email*
Email Used On Application
Date*

MonthDayYear
Date
Signature (Please sign below to confirm your authorization)*

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