Download a Pre-Employment Screening Questionnaire

Download a Pre-Employment Screening Questionnaire
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Screening possible job candidates using questionnaires solicits basic information from the candidate and serves as the first step in pre-employment screening and verification. Such a check verifies the employee’s education and experience claims, and performs criminal, credit history, and other checks to verify the integrity of the candidate.

Download a free pre-employment screening questionnaire from the Bright Hub Media Gallery. This is a generic form suitable for all positions. Feel free to change the questions as needed, based on your business requirements and state-specific laws.

The questionnaire for pre-employment screening is a preliminary questionnaire to be administered to the candidate after the interview, or after shortlisting the candidate for selection. The candidate has to fill up the form themselves and return it to the human resource department. On receipt of the information contained in the questionnaire, the employer can opt to entrust the background check to a third party agency and seek specific authorization from the candidate to conduct the check.


The questionnaire is self explanatory, and captures the following information

  • The candidate’s full name, and previous names of the candidate. The names in which the candidate was previous known under becomes indispensable to perform an effective criminal background and other checks.
  • Employee’s date of birth, social security number, and driving license number. Such basic information helps identify the employee during a criminal, credit history, and other background checks, and allows checking for the employees’ citizenship or eligibility to work.
  • Details of employee’s home address for last seven years. This allows for limiting the search to specific states.
  • Details of employee’s employment history for last seven years, to ascertain the candidate’s nature of job responsibilities, work related performance, attitude, conduct, salary, and other work related details.
  • Details of employee’s last education qualification, to verify educational qualifications.

One important point to consider is the items in the questionnaire comply with relevant legislation. The Fair Credit Reporting Act limits background checks to the previous seven years. Some states impose restrictions on asking for a person’s date of birth. Asking for date of birth, social security number, and other personal information may also invite charges of discrimination unless the employer can prove the relevance of such data for making the hiring decision.

How to Use

Please note the questionnaire only helps capture the relevant data and is by itself incomplete for use in pre-employment screening and verification. The questionnaire provides for a general authorization that allows the employer or agents to seek information about the candidate and prepare a Consumer Report / Investigative Consumer Report., but the law requires the candidate to issue a separate detailed and specific authorizations for potential employers to obtain medical, criminal, and other information from the relevant agencies.

If the candidate applies for a job that pays less than $75,000 a year, and third party agents carry out any part of the pre-employment screening and verification, the Fair Credit Reporting Act (FCRA) applies. The FCRA places restriction on conducting some types of background verification searches.

A comprehensive and proper pre-employment screening and verification protects the organization from the liability a potentially dangerous employee could bring about.


  1. True Background Screening. “Pre Employment Screening Questionnaire.” Retrieved April 25, 2011.
  2. “The Ultimate Guide to Conducting Background Checks.” Retrieved April 25, 2011.

Image Credit: Howden