Reference Check Form – Private and Confidential
I. Candidate’s Information
Candidate’s name: Hadiel Mohamad Issa
Position Under Consideration: Lab Technician
Level and Location:
II. Reference Provider
Name: Mohamad Sulaiman
Current Role and Organization: HR Officer – Human Call Association
Telephone Number: 81252202
E-mail Address: [Link]@[Link]
III. Nature of the Relationship
I was the candidate’s: Supervisor Colleague Subordinate Professor
Other (please specify):
Organization/Employer where you Human Call Association
worked with the candidate:
Please provide any additional
context/comments on the nature
of your professional relationship:
Duration of relationship: From (01/06/2015) to (31/03/2018)
IV. Performance Questions:
a. How would you rate the candidate’s technical skills and professional expertise relevant to their
role?
Poor Satisfactory Very good Outstanding
Comments (optional):
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b. How would you rate the candidate’s ability to work effectively with peer colleagues,
subordinates, and supervisors?
Poor Satisfactory Very good Outstanding
Comments (optional):
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c. How would you rate the candidate’s overall performance, including their ability to manage
workload, meet deadlines, and deliver results?
Poor Satisfactory Very good Outstanding
Comments (optional):
Reference Check Form – Private and Confidential
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d. Did the candidate demonstrate integrity and sound ethical judgment in their work?
Yes ☐ No
If no, please elaborate:
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e. To the best of your knowledge, was the candidate subject to any conduct-related issues,
investigations or disciplinary actions during their employment?
Yes No
If yes, please elaborate:
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f. Would you rehire or recommend this candidate for a similar role?
Strongly recommend Recommend Not recommended
Please briefly explain your response:
She had sufficient experience and a good reputation.
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g. Is there anything further you would like to add to support our assessment of the candidate?
No Comment
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V. Reference Provider Confirmation
Signature: Mohamad Sulaiman
Date: 01/06/2026
VI. For HR use only (if negative reference or if references obtained by telephone)
Were any concerns identified during the reference check?
☐ Yes ☐ No
Comments/
Actions:______________________________________________________________________________
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Reference Check Form – Private and Confidential
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Name and Title:
Signature:
Date: