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Reference Request Consent Form for the United States

Reference Request Consent Form Template for United States

A Reference Request Consent Form is a legal document used in the United States that provides formal authorization for current or former employers to share employment-related information with prospective employers. This document ensures compliance with federal and state privacy laws, the Fair Credit Reporting Act, and employment regulations while protecting both the employer and employee in the reference-checking process.

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Reference Request Consent Form

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What is a Reference Request Consent Form?

The Reference Request Consent Form is essential in modern U.S. employment practices where privacy laws and liability concerns have made employers increasingly cautious about providing references. This document provides legal protection for all parties involved by explicitly defining what information can be shared, with whom, and for how long. It ensures compliance with federal regulations including the FCRA and state-specific employment laws, while protecting against potential defamation claims. The form is typically used during job applications or when an employee is seeking new employment opportunities.

What sections should be included in a Reference Request Consent Form?

1. Employee Information: Details of the employee providing consent, including full name, current/former position, and dates of employment

2. Scope of Consent: Detailed specification of what information is authorized for disclosure, including employment dates, job titles, job responsibilities, performance evaluations, and salary information

3. Duration: Specification of the time period for which the consent remains valid, including start date and expiration date if applicable

4. Authorization Statement: Explicit consent statement acknowledging understanding and agreement, including signature block, date, and witness provisions

What sections are optional to include in a Reference Request Consent Form?

1. Revocation Rights: Section detailing the process and conditions under which consent can be withdrawn, including notification requirements

2. Third Party Recipients: Specific identification of parties authorized to receive information, including potential employers or verification services

3. Limitation of Liability: Provisions releasing the former employer from liability for providing authorized information in good faith

What schedules should be included in a Reference Request Consent Form?

1. Schedule A - Authorized Information Checklist: Detailed checklist of specific information categories that may be shared, including performance ratings, attendance records, and reason for departure

2. Schedule B - Authorized Recipients List: Comprehensive list of specific companies, organizations, or individuals authorized to receive reference information

Authors

Alex Denne

Head of Growth (Open Source Law) @ Ƶ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Jurisdiction

United States

Publisher

Ƶ

Document Type

Consent Letter

Cost

Free to use
Clauses












Industries

Fair Credit Reporting Act (FCRA): Federal law that regulates the collection, dissemination, and use of consumer information, including employment background checks and references

Privacy Act of 1974: Federal law governing the collection, maintenance, use, and dissemination of personal information maintained by federal agencies

Americans with Disabilities Act (ADA): Federal law protecting individuals with disabilities from discrimination, including in reference-giving contexts

Title VII of the Civil Rights Act of 1964: Federal law prohibiting employment discrimination based on race, color, religion, sex, and national origin, which must be considered in reference-giving processes

EEOC Guidelines: Federal guidelines ensuring equal employment opportunity and non-discrimination in employment practices, including reference checks

State Employment Laws: Varying state-specific regulations governing employment relationships and reference-giving practices

State Privacy Laws: State-specific regulations governing the protection and handling of personal information

Defamation Laws: Legal framework protecting against false statements (libel and slander) in reference-giving contexts, including qualified privilege considerations

Consent Requirements: Legal requirements for obtaining explicit consent, including specification of shared information, duration, and right to revoke

Liability Limitations: Legal provisions limiting liability for reference providers when acting in good faith and within consent parameters

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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