---

Background Check & Reference Contact Consent

As part of the hiring process, Love Abides Eldercare may conduct a background check and contact references to verify the information provided in your application and to assess your qualifications for employment.

By signing below, you acknowledge and agree to the following:

I, ____________________, authorize Love Abides Eldercare to conduct background checks, which include OIG and criminal history, as permitted by law.

I, ____________________, give permission for Love Abides Eldercare to contact the professional and/or personal references I have provided.

I, ____________________, understand that this information will be used solely for employment purposes and will be kept confidential.


Applicant Signature: __________________
Date: June 2, 2026