PERSONAL OR CHARACTER REFERENCE REQUEST
The candidate has provided us with your details as a character referee.
Please could you kindly complete, sign and submit the form below.
Fields marked * are required to be completed.
The post applied for is subject to Regulation 19(3)(a) of the Health and Social Care Act (Regulated Activities) Regulations 2014 which requires us to ensure all “Persons employed” by our organisation (including agency, bank staff and volunteers) must:
a. Be of good character
b. have the qualifications, competence, skills, and experience which are necessary for the work to be
performed by them, and
c. be able by reason of their health, after reasonable adjustments are made, of properly performing tasks
which are intrinsic to the work for which they are employed.
It is essential to request a reference from a previous employer, and the employee cannot be expected to find work of this type unless his or her employer provides a full and frank reference to a prospective employer.
When completing this reference organisations have a responsibility to ensure that the reference is accurate and does not contain any misstatement and nothing significant is omitted
Please rate the candidate's personal skills and character for each of the headings
This form contains personal data as defined by UKGDPR/DPA 2018. It may include special category data (Article9) and/ criminal offence data (Article 10) which has been requested for the purposes of recruitment and
safeguarding adults at risk and/or children. As we are the organisation requesting this data, we will protect any
information disclosed within the form in line with data protection requirements and ensure it is not passed to
anyone who is not authorised to see the information.
The content of the reference may be discussed with the candidate; in addition, the candidate may request and be
granted access to the reference.
HOWEVER, if this reference is marked as confidential, the UKGDPR/DPA 2018 creates an exemption from:
• The right to be informed (privacy information)
• The right to make a subject access request.
Therefore, if this reference is marked as confidential, and the candidate makes a subject
request BOTH the company who issued it and the company who received it – would be exempt from having to
provide a copy. It can only be disclosed to whom it is addressed and will not be released
to a third party.
Thank you for completing this form for us!
Reference has been submitted!
Reviewed February 2024
Next review due February 2025
