Get Background Check Information, Consent And Disclosure Form - Med Umich

Filling out the Background Check Information, Consent and Disclosure Form is a crucial step in the employment process at the University of Michigan Health System. This guide will provide you with clear, step-by-step instructions to help you accurately complete the form online.

Follow the steps to successfully complete the form.

1. Press the 'Get Form' button to access the form and open it in your preferred document editor.
2. Begin with Part 1 – Demographic Information. Fill out the fields with your personal details, including your first name, last name, date of birth, place of birth, and contact details. Ensure that you enter all information clearly and accurately.
3. Proceed to Part 2 – Consent. Read the consent statements carefully. You must provide your signature and date to authorize the University to conduct the required background checks.
4. In Part 3 – Disclosures, certify your criminal history. Choose one of the provided options regarding your criminal record and disclose any necessary offenses, if applicable. Make sure all information is truthful and complete.
5. Continue to Part 4 – Conditional Employment/Retention/Assignment. Read the terms regarding your responsibilities and potential consequences for inaccuracies. Sign and date this section.
6. Finally, in Part 5 – Applicant Rights, acknowledge your rights regarding disqualifying records and potential inaccuracies. Sign and date this section to confirm your understanding.
7. After completing all sections, review your entries for accuracy. Save changes to your document, then proceed to download, print, or share the completed form as required.

Ready to start? Complete your Background Check Information, Consent and Disclosure Form online today.