Complete a Clinic Consent Form Sample Clauses

Complete a Clinic Consent Form. In each and every case, read the form to the employee prior to obtaining the employee's signature authorizing the test and release of positive or negative test results. No changes are to be made on the consent form. Both the observing witnesses shall complete the Behavior Report Form. In completing the Behavior Report Form, the witnesses shall be as accurate and detailed as possible, recording their observations of the employee's behavior which led to their decision or require an exam/test. The witnesses shall state what they actually observed, but refrain from making statements about possible causes of the behavior or making judgmental conclusions. 1. Make it clear to the employee that the request to sign the form and take the exam/test is a direct order. 2. Ask the employee if he/she understands the order. (If the employee responds that he/she does not understand the order, explain your order again.) 3. Explain to the employee that failure to comply with the order constitutes insubordination which will result in termination. 4. Issue a second direct order to sign the form and take the exam/test. 5. If the employee refuses, inform the employee that he/she will be terminated.
Sample 1Sample 2Sample 3See All (6)
AutoNDA by SimpleDocs
Complete a Clinic Consent Form. In each and every case, read the form to the employee prior to obtaining the employee's signature authorizing the test and release of positive or negative test results. No changes are to be made on the consent form. Both the observing witnesses shall complete the Behavior Report Form. 1. Make it clear to the employee that the request to sign the form and take the exam/test is a direct order. 2. Ask the employee if he/she understands the order. (If the employee responds that he/she does not understand the order, explain your order again.) 3. Explain to the employee that failure to comply with the order constitutes insubordination which will result in termination. 4. Issue a second direct order to sign the form and take the exam/test. 5. If the employee refuses, inform the employee that he/she will be terminated.
Sample 1

Related to Complete a Clinic Consent Form

  • Supplemental Work Authorizations Before additional work may be performed or additional costs incurred, a change in a work authorization shall be enacted by a written supplemental work authorization in the form identified and attached hereto as Attachment D. Both parties must execute a supplemental work authorization within the period of performance specified in the work authorization. The State shall not be responsible for actions by the Engineer or any costs incurred by the Engineer relating to additional work not directly associated with the performance or prior to the execution of the work authorization. The Engineer shall allow adequate time for review and approval of the supplemental work authorization by the State prior to expiration of the work authorization. Any supplemental work authorization must be executed by both parties within the time period established in Article 2 of the contract, (Contract Period). Under no circumstances will a work authorization be allowed to extend beyond the contract's expiration date or will the total amount of funds exceed the maximum amount payable set forth in Article 3A of the contract (Compensation).

  • Attachment  C_ CONTRACT AFFIRMATIONS For purposes of these Contract Affirmations, HHS includes both the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS). System Agency refers to HHSC, DSHS, or both, that will be a party to this Contract. These Contract Affirmations apply to all Contractors and Grantees (referred to as “Contractor”) regardless of their business form (e.g., individual, partnership, corporation). By entering into this Contract, Contractor affirms, without exception, understands, and agrees to comply with the following items through the life of the Contract:

  • Please see the current Washtenaw Community College catalog for up-to-date program requirements Conditions & Requirements

  • COMPLETE AGREEMENT; AMENDMENTS This Agreement is the complete and exclusive agreement between the parties with respect to the subject matter contemplated thereby. No modifications to this Agreement shall be made or binding unless made in writing and signed by all parties to this Agreement.

  • CONTRACT EXHIBIT I PREFERRED PRICING AFFIDAVIT This preferred-pricing affidavit is entered into in accordance with section 216.0113, F.S., and as required by Contract No. 80101507-21-STC-ITSA (“Contract”) between (“Contractor”) and the Department of Management Services. As the person authorized by Contractor to sign this affidavit, I attest that the Contractor is in full compliance with the preferred-pricing clause of the Contract. Contractor’s Name: By: Signature Printed Name/Title Date: STATE OF COUNTY OF Sworn to (or affirmed) and subscribed before me this day of , by Vendor Name: FEIN# Vendor’s Authorized Representative Name and Title: Address: City, State, and Zip code: Phone Number: ( ) - E-mail: CORPORATE SEAL (IF APPLICABLE) (Print, Type, or Stamp Commissioned Name of Notary Public) [Check One] Personally Known OR Produced the following I.D.

  • Assignment Amendments Waiver and Contract Complete A. AUDIT.

  • Counterparts and Consent to Do Business Electronically This Agreement may be executed in multiple counterparts, each of which shall be deemed to be an original, but together they shall constitute one and the same instrument. Facsimile and .pdf signatures shall be deemed valid and binding to the same extent as the original and the parties affirmatively consent to the use thereof, with no such consent having been withdrawn. Each party agrees that this Agreement and any documents to be delivered in connection with this Agreement may be executed by means of an electronic signature that complies with the federal Electronic Signatures in Global and National Commerce Act, state enactments of the Uniform Electronic Transactions Act, and/or any other relevant electronic signatures law, in each case to the extent applicable. Any electronic signatures appearing on this Agreement and such other documents are the same as handwritten signatures for the purposes of validity, enforceability, and admissibility. Each party hereto shall be entitled to conclusively rely upon, and shall have no liability with respect to, any electronic signature or faxed, scanned, or photocopied manual signature of any other party and shall have no duty to investigate, confirm or otherwise verify the validity or authenticity thereof.

  • NATIONAL JOINT COUNCIL AGREEMENTS 22.1 Subject to the National Joint Council By-Laws, agreements concluded by the National Joint Council of the Public Service on items which may be included in a collective agreement, and which the parties to this agreement have endorsed after December 6, 1978, will form part of this collective agreement, subject to the Federal Public Sector Labour Relations Act (FPSLRA) and any legislation by Parliament that has been or may be, as the case may be, established pursuant to any Act prescribed in Section 113(b) of the PSLRA. 22.2 NJC items which may be included in a collective agreement are those items which the parties to the NJC agreements have designated as such or upon which the Chairman of the Federal Public Sector Labour Relations Board has made a ruling pursuant to (c) of the NJC Memorandum of Understanding which became effective December 6, 1978 22.3 The following directives, as amended from time to time by National Joint Council recommendation and which have been approved by the National Research Council Canada, form part of this Agreement: - Bilingualism Bonus Directive - Commuting Assistance Directive - Occupational Health and Safety Directive - Relocation Directive - Travel Directive - First Aid to the General Public – Allowances for Employees - Public Service Health Care Plan - Uniforms Directive 22.4 During the term of this Agreement, other directives may be added to the above noted list. 22.5 Grievances in regard to the above directives shall be presented in accordance with clause 19.1 of the Grievance Procedure article of this Agreement.

  • Counterparts; Electronically Transmitted Documents and Signatures The parties may execute this Agreement in one or more counterparts, each of which are deemed an original and all of which together constitute one and the same instrument. The parties may deliver this Agreement, including signature pages, by original or digital signatures, or facsimile or emailed PDF transmissions, and the parties hereby adopt any documents so received as original and having the same effect as physical delivery of paper documents bearing the original signature.

  • Approval of Plans and Specifications The Plans and Specifications will conform to the requirements and conditions set out by applicable law or any effective restrictive covenant, and to all governmental authorities which exercise jurisdiction over the Leased Premises or the construction thereon.

Draft better contracts in just 5 minutes Get the weekly Law Insider newsletter packed with expert videos, webinars, ebooks, and more!