Employee Consent to Drug Test

for Your State

Consent to Drug Test for employees and prospective employees.

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This form is designed to assist you in preparing an agreement through which prospective employees consent to take a drug or alcohol test prior to employment.

Many employers choose to test their prospective employees for recent drug or alcohol use during their application review process. It is important to note, however, that many states have enacted legislation limiting (and in some cases prohibiting altogether) a company’s ability to test applicants or employees in this manner. In some of these contexts, such tests are permitted where the company can show that they are necessary, i.e., an applicant being considered for a position operating heavy machinery.

Among others, this form includes the following provisions:
• Consent
• Purpose
• Condition for Employment
• Release
• Substances
• Positive Tests
Number of Pages2
DimensionsDesigned for Letter Size (8.5" x 11")
EditableYes (.doc, .wpd and .rtf)
UsageUnlimited number of prints
Product number#28107
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.
 
 
Consent to Drug/Alcohol Test

 

 
1.   Consent.  I,    (Name of employee)      , hereby consent to be tested for the presence of the substances set forth below in Section 5 (the “Test”).
 
2.  Purpose.      (Name of company)    has informed me about its drug/alcohol testing policy.    (Name of company)   tests for the presence of the substances set forth in Section 5, for the purpose of    (briefly describe purpose of drug testing, i.e., safety concerns)                                                        .
 
3.  Condition to Employment.  I understand that the Test is a prerequisite to employment with   (Name of company)   , and that if I refuse to take the Test, or if I in any way attempt to manipulate or frustrate the Test or the results of the Test,    (I will be terminated from employment/my application for employment will be denied)   .
 
4.  Release.  I hereby consent to the release of the results of the Test from   (Company conducting the test)    to   (Name of company)   , and understand that the results of the Test will be kept confidential by   (Name of company)   , and the results of the Test will not be disclosed to any person other than me, and employees or officers of      (Name of company)    where necessary to the employment application/review or hiring process.
 
5.  Substances.  The Test shall be implemented to test me for the following substances:           (List the substances to be tested for:                                                                                                                                                        .
 
6.  Positive Tests.  I understand that if the Test is positive for any of the above substances, I will have an opportunity to explain the positive result to        (Name of company)   .  If I am unable to offer a satisfactory explanation for the positive result, I understand that    (I will be terminated from employment/my application for employment will be denied)   .
 
 
               
Applicant Signature
 
               
Applicant Name (Please print)
 
               
Date

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