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CONSENT FOR DRUG/ALCOHOL TESTING
If you are offered and accept employment with____________ (company),
in the interest of safety for all concerned, you will be required
to take a urine test for drug and/or alcohol use.
I,_______________, have been fully informed of the reason for this
urine test for drug and/or alcohol (I understand what I am being
tested for), the procedure involved, and do hereby freely give my
consent. In addition, I understand that the results of this test
will be forwarded to my potential employer and become part of my
record.
If this test is positive, and for this reason I am not hired,
I understand that I will be given the opportunity to explain
the results of this test.
I hereby authorize these test results to be released
to__________________________________
(company name).
Signature____________________________________________Date______
Witness ____________________________________________Date_______
