Alcohol and drug consent forms

• [DOCX File]Consent - Washington State

  https://info.5y1.org/alcohol-and-drug-consent-forms_1_f9b3b7.html

  Client: Have client or a child over age of consent (13 for mental health and drug and alcohol services; 14 for HIV/AIDS and other STDs; any age for birth control and abortions; 18 for health care and other records) sign this box and insert the date of signature. The …

  drug test authorization form template

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• [DOCX File]Drug and Alcohol Testing Consent Form

  https://info.5y1.org/alcohol-and-drug-consent-forms_1_c5c5d3.html

  DRUG/ALCOHOL TESTING CONSENT FORM. I, _____, hereby give my consent to authorize my employer known as _____ and the testing laboratory designated to conduct analytical tests deemed necessary, on an ongoing basis, to determine the absence or the presence of ☐ - Alcohol ☐ - Class A Drugs (heroin, cocaine, etc.) ☐ - Class B Drugs (cannabis ...

  drug screen form

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• [DOC File]CONSENT TO RELEASE CONFIDENTIAL INFORMATION

  https://info.5y1.org/alcohol-and-drug-consent-forms_1_62bc29.html

  I understand that the above information will be disclosed from records whose confidentiality is protected by the federal confidentiality of substance abuse patient records statute, section 643 of the Public health Service Act, 42 U.S.C. 290dd-2, and its implementing regulation, 42 C.F.R.R., part 2; the Health Insurance Portability and ...

  random drug test form

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• [DOC File]Drug & Alcohol Testing Notification & Consent - State Rail ...

  https://info.5y1.org/alcohol-and-drug-consent-forms_1_0eeef2.html

  STATE RAIL AUTHORITY. DRUG/ALCOHOL TESTING NOTIFICATION & CONSENT. I understand, as required by Title 49, Code of Federal Regulations, Parts 40 and 212, and by the policy of the West Virginia Department of Transportation, State Rail Authority, any prospective employee (or a present employee entering into a covered position) who is to perform a safety-sensitive function:

  drug and alcohol release forms

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• [DOCX File]hr.nv.gov

  https://info.5y1.org/alcohol-and-drug-consent-forms_1_2e0ed3.html

  Alcohol/Drug Test Consent Form TS-76. Page 1 of 1Rev. 4/16. ALCOHOL/DRUG TEST CONSENT FORM. EMPLOYER: If applicable, state objective facts giving rise to the belief that the employee is under the influence of alcohol or a controlled substance. ...

  alcohol testing form

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