/f048f96b-345c-4acc-aff7-47e94611c1b2_1.png)
Employee Drug Alcohol Test Consent Form
What to write in a drugs and alcohol consent form? Why are drug tests conducted in the workplace? Download this consent form and save time in creating your own
Review Rating Score
Overview
Employee Drug and Alcohol policy at the workplace?
Screening tests determine whether the drug is positive and what type it is. During this test, employees are first evaluated to determine whether they are under the influence of drugs. Contrary to screening tests, confirmatory tests confirm positive results.
Employee Drug Alcohol Test Consent Form
I understand that submission to a Post-Injury Drug And/or Alcohol Screen is a condition of employment with this employer. I understand that, should my testing results be confirmed positive or I refuse to test, I will be subject to the company’s disciplinary action, including possible discharge. I understand that a tampered with or an adulterated specimen will be considered a refusal to test, resulting in possible discharge.
I hereby give my consent to release the results of my blood and/or urinalysis to the person(s) or department(s) or the specified agent of my employer, including my employer’s Workers’ Compensation Insurance Company, for the purpose of determining the presence of alcohol and/or other drugs in my body for the duration of my employment.
I understand that if I am injured during the course and scope of my employment and I test positive for the presence of alcohol and/or drugs, I may forfeit my eligibility for medical and indemnity benefits. I also understand that a refusal to test, a tampered with or an adulterated specimen under this circumstance may also result in forfeiture of my eligibility for medical and indemnity benefits and immediate action, including possible discharge.
By signing this form, I hereby release to the Company and/or Company’s Medical Review Officer the results of the test(s) to which I have consented. I further authorize the Company to discuss the results with medical personnel / physician collecting the specimen, the testing facility, its directors, officers, agents, and employees responsible for administering the aforementioned test(s) or evaluating the results thereof and any of them herein. I also authorize the Company to discuss the results with its legal advisors and to use the test results as a defense to any legal action to which I am a party.
I further release any testing facility or any physicians who have tested me from any liability arising from a release of any and all results, written reports, medical records, and data concerning my test(s) to the appropriate Employer officials. I agree to have the results released to..............
What are the reasons for companies testing for alcohol?
In order to make it clear to prospective employees that they will not tolerate any kind of alcohol abuse at their workplace, many employers conduct breath alcohol tests. The employee handbook usually includes information about drug and alcohol testing to make sure employees are aware of company policies.
Our website provides a free sample employee consent form for drug and alcohol testing. The document in Microsoft Word can be updated with the sentences you like. We'd appreciate a big thumbs up if you liked this letter. You matter a lot to us in terms of your valuable feedback. We have some useful content on our website.
Is the content above helpfull?
Thanks for letting us know!
Reviews
Joey Koch(12/1/2022) - USA
Thank you for the template
Hendrick M(12/1/2022)
Useful HR policy and consent form for my business. Many of my guys are easily temped
Last modified
Our Latest Blog
- Writing a Great Resume: Tips from a Professional Resume Writer
- How to build accurate and compliant documents faster
- How to Create Halloween Party Invitations? 2023
- Document Editing and Creating in 2022
Related keywords
Need help?
We are standing by to assist you. Please keep in mind we are not licensed attorneys and cannot address any legal related questions.
-
Chat
Online - Email
Send a message
You May Also Like

Firearm Repair Log Template

Equipment Release Form Template

Equipment Maintenance Tracking Template

Equipment Maintenance Log Template

Equipment Lease Agreement Form

Educational Guardianship Form

English Birth Certificate Translation Form

Executive Summary Form

Proposal Form Template for Events

Event Proposal Form Template

Form For Estimating Jobs

Employee Write Up Form Sample

Template for employee self-evaluation

Employee Self-Evaluation Sample

Employee Meeting Sign In Sheet Template

Employee Exit Interview