Background Check Authorization Form
Sign in to Google to save your progress. Learn more
Email *
Disclosure
All independent contractor relationships with Kehoe's Veterinary & Operational Services are contingent upon clear results of a thorough background check. Background checks will be conducted on all KVOS subcontracts, as a good faith measure for the Clients.

I understand reports on me will be obtained by a background check vendor and provided to the Company all information about or concerning me, including but not limited to: my past or present employers; learning institutions, including colleges and universities; law enforcement and all other federal, state and local agencies; federal, state and local courts; the military; credit bureaus; testing facilities; motor vehicle records agencies; if applicable, worker’s compensation injuries; all other private and public sector repositories of information; and any other person, organization, or agency with any information about or concerning me. Workers’ compensation information will only be requested in compliance with federal Americans with Disabilities Act and/or any other applicable federal, state or local laws.

The information that can be disclosed to the background check vendor and its agents includes, but is not limited to, information concerning my employment history, earnings history, education, credit history, motor vehicle history, criminal history, military service, professional credentials and licenses and substance abuse testing.

I agree the Company may rely on this authorization to order background reports, including investigative consumer reports, from companies other than the background check vendor without asking me for my authorization again as allowed by law. I also agree that a copy of this form is valid like the signed original.

If an investigative consumer report is obtained, you have the right to request, in writing, a complete and accurate
disclosure of the nature and scope of any investigative consumer reports as well as an additional written summary of your rights under the Fair Credit Reporting Act by making such request in writing within a reasonable period of time to the Company. If you so request, you will be provided that information no later than five (5) days after we receive your written request or no later than five (5) days after the date on which we request the investigative consumer report, whichever is later.


Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy