Background Check Request Form

How would you like the background check to be submitted?*

Genetics On-The-Go will collect the applicant's information and run the check. (Enter the applicant's information below so we can complete the background check directly.)Send the applicant a secure link to complete their own information. (Provide only the employee's name and email and they will receive a secure link to enter their own details.)

Request Date*

Date

Employee's Name*

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Gender*

MaleFemale

Employee Email*

example@example.com

Job position/title

Job Location (State/City)*

Requester's Name*

First NameLast Name

Requester's Email*

example@example.com

Requester's Phone Number*

Please enter a valid phone number.

My Products

Basic Plus Criminal Background CheckGlobal Watchlist Search, National Criminal Search (Standard), Sex Offender Search, SSN Trace.

$70.00

Essential Criminal Background CheckCounty Criminal Search (Last 7 years), Global Watchlist Search, National Criminal Search (Standard), Sex Offender Search, SSN Trace.

$115.00

Complete Criminal Background CheckCounty Criminal Search (Last 7 years), Federal Criminal Search (Last 10 years), Global Watchlist Search, National Criminal Search (Standard), Sex Offender Search, SSN Trace, State Criminal Search (Last 7 years).

$160.00

Motor Vehicle Record Background CheckReviews driver's license status, violations, and driving history.

$25.00

Employment Verification (Non-DOT)Confirms past employment history.

$80.00 Quantity

DOT Employment VerificationVerifies safety-sensitive employment records required for DOT compliance.

$100.00 Quantity

Education VerificationConfirms diplomas, degrees, or certifications earned.

$50.00 Quantity

Alias SearchesChecks for records under previous names, nicknames, or aliases.

$70.00 Quantity

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Do you want to send the background check to a recipient?

YesNo

Name of the Receiver

First NameLast Name

Email of the Receiver

example@example.com

Background Check Request Form

Payment Information

Payment Methods