Staffing Agency Reference Check Form
Please provide reference information and structured feedback regarding the job candidate. All sections are required for a comprehensive review.
Candidate’s Full Name
*
First Name
Last Name
Referee’s Full Name
*
First Name
Last Name
Referee’s Email Address
*
example@example.com
Referee’s Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Your Relationship to the Candidate
*
Please Select
Direct Supervisor
Colleague
Manager
Client
Other
Reference Period (Start Date)
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reference Period (End Date)
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
How would you rate the candidate’s overall job performance?
*
1
2
3
4
5
Please evaluate the candidate’s reliability and professionalism.
*
Excellent
Good
Average
Below Average
Additional comments on the candidate’s strengths, areas for improvement, and suitability for future roles.
Submit Reference
Should be Empty: