* = Required Information

Drug Test Consent Form

I, , freely give my consent for this drug and/or alcohol test. I have been fully informed of the reason for this urine test and I understand that the results will be forwarded to my supervisor. If the test results are positive, I will be given the opportunity to explain the results before any action is taken.

Reason for Test: Other

Reason for Test:

PRE- EMPLOYMENT OR ACCIDENT

Other

Security code