Applicant Drug and Alcohol Test Consent Form
As a
prospective employee of {INSERT COMPANY NAME} ("the Company"), I
understand that the use of drugs, alcohol and other controlled substances in
the workplace creates a safety concern for all employees. Â In the interest of creating a safe working
environment, I hereby give my consent for the Company to conduct the drug and
alcohol tests it considers necessary as outlined in the Drug Test policy and I
understand that these  tests are a
condition for employment. Â
I authorize
the Company to take the necessary specimens from me to test for drugs, alcohol
and other controlled substances, and I authorize laboratory or medical
personnel retained by the Company for these tests to release the results to {INSERT
COMPANY NAME}. Â I further understand
that if the tests are positive, and for this reason I am not hired, I will be
given the opportunity to explain the results of this test. Â I release the laboratory or medical
personnel conducting the drug test, the Company, and the Company´s employees,
directors, officers and successors from any liabilities, claims and causes of
action, known or unknown, contingent or fixed, that may result from these tests
and I agree not to file any lawsuits or other actions to assert a claim.
________________________ Â Â Â Â Â Â Â Â Â Â Â
Print Name
________________________
Signature
________________________
Date