Drug Free Workplace Program Pre-Employment Consent Form
(YOUR COMPANY LETTERHEAD)
I hereby consent to submit to the testing for drugs and/or alcohol as shall be determined by
(Your Company Name) in the selection process of applicants for employment, for the
purpose of determining the drug and/or alcohol content thereof.
I agree that Drug Test Today may collect these specimens for these tests and may test them, if qualified, or forward them
to a licensed or certified laboratory designated by the company for analysis. I further agree to and
hereby authorize the release of said test results to the company.
I understand that my current use of illegal drugs may prohibit me from being employed at this
Company.
I further agree that a reproduced copy of this pre-employment consent and release form shall
have the same force and effect as the original.
I have carefully read the foregoing and fully understand its contents. I acknowledge that my
signing of this consent and release form is a voluntary act on my part and that I have not been
coerced into signing this document by anyone.
Applicant:
Print Name:_____________________________ SS#:__________________
Applicant Signature:_________________________ Date:________________
Witness Print
Name:________________________________________________________
Witness
Signature:______________________________ Date:___________________