DRUG AND ALCOHOL SCREEN EXAM CONSENT FORM Sample Clauses

DRUG AND ALCOHOL SCREEN EXAM CONSENT FORM. Employee Name Social Security No. Date of Birth / / M F Date / / Time am/pm Name of Supervisor/Agent Requesting Exam Name of Appointing Authority or Designee Authorizing Testing Medical Consent: I consent to an examination and the collection of blood and urine specimens by and the release of the test results by laboratory as requested by the (Appointing Authority) to determine the presence of alcohol and/or drugs, if any.
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Related to DRUG AND ALCOHOL SCREEN EXAM CONSENT FORM

  • DRUG AND ALCOHOL TESTING The employer reserves the right to introduce drug and alcohol testing during the life of this agreement. Prior to introduction of testing there will be reasonable consultation with the employees.

  • DRUG AND ALCOHOL FREE WORKPLACE 20.1 All employees must report to work in a condition fit to perform their assigned duties unimpaired by alcohol or drugs.

  • Drug and Alcohol Testing Permitted Testing is permitted where the Employer has reasonable suspicion to believe.

  • DRUG/ALCOHOL TESTING 8.1 The parties agree that the maintenance of a drug/alcohol free work place is a goal of both the College and the Union. Employees are prohibited from possession, consumption and/or being under the influence of a controlled substance/alcohol while on the College’s premises or during time paid by the employer. Violations of this prohibition may result in a disciplinary action up to and including termination.

  • Drug-Free Workplace Certification As required by Executive Order No. 90-5 dated April 12, 1990, issued by the Governor of Indiana, the Contractor hereby covenants and agrees to make a good faith effort to provide and maintain a drug-free workplace. The Contractor will give written notice to the State within ten (10) days after receiving actual notice that the Contractor, or an employee of the Contractor in the State of Indiana, has been convicted of a criminal drug violation occurring in the workplace. False certification or violation of this certification may result in sanctions including, but not limited to, suspension of contract payments, termination of this Contract and/or debarment of contracting opportunities with the State for up to three (3) years. In addition to the provisions of the above paragraph, if the total amount set forth in this Contract is in excess of $25,000.00, the Contractor certifies and agrees that it will provide a drug-free workplace by:

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