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Consent to Drug and Alcohol Testing

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Consent to Drug and Alcohol Testing

Consent to Drug and Alcohol Testing

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Sample Text: (Formatting does not match the actually Forms)

Consent to Drug and Alcohol Testing
1. THE PARTIES TO THIS AGREEMENT ARE:


1.1 THE COMPANY (hereinafter referred to as Company):

Full Name:
________________________________________________________________________

Physical Address:
________________________________________________________________________
________________________________________________________________________


1.2 THE EMPLOYEE (hereinafter referred to as Employee):

Full Name:
________________________________________________________________________
If you are offered and accept employment with the above named Company you will be working with and around machinery and equipment that can cause injury to yourself and others. In the interest of safety, you will be required to take and pass a urine test for drug and/or alcohol use. This test is a standard part of the application for employment in the position for which you are applying with said Company.
My signature below signifies that I, the undersigned Employee have been fully informed by my potential employer 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. I also understand that the results of this test will be sent to my potential employer and become part of my personnel 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 authorize these test results to be released to the above Company.
IN WITNESS WHEREOF, Company and Employee have executed, entered into and delivered this Agreement as of the date first set forth above.

This Agreement is made this _____ day of ____________, 20 ___, by

Employee’s Name: ________________________________________________________________________


By _____________________________________________
Signature Date

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