Post-Accident Drug &

Alcohol Testing Policy

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SAMPLE DRUG POLICY

Company-Wide “Post-Accident” Drug & Alcohol Testing Policy

PURPOSE

Management of (Organization name) recognizes that drug and alcohol abuse poses a serious threat to the safety and general well being of all our employees.

It also plays a big part in the overall efficiency and productivity that all our jobs depend upon.

The purpose of our “new” post-accident, drug and alcohol testing program is to ensure a safe working environment for all our employees.

DEFINITION

Controlled Substance: A controlled substance means any item listed in Schedule I through V of the Federal Controlled Substance Act. Such substances include, but are not limited to:

  • MARIJUANA
  • OPIATES
  • AMPHETAMINES
  • COCAINE
  • CRACK PHENCYCLIDINE
  • NARCOTICS, BARBITURATES
  • STIMULANTS, DEPRESSANTS
  • ALL OTHER SUBSTANCES THAT ALTER PERCEPTION OR IMPAIR PHYSICAL OR MENTAL PERFORMANCE

Additionally, this includes ALCOHOL in one’s body above the legal limits of individual states.

As used in this COMPANY POLICY, controlled substances also include any substance, the use, possession, or sale of which is illegal under FEDERAL OR STATE LAW, and any substance which cannot be purchased over the counter and which is not prescribed and being used under the supervision of a physician.

POLICY STATEMENT

A) The manufacture, distribution, dispensation, possession, or use of a controlled substance on our Company premises or that of our client’s, including vehicles, parking lots, while on Company business, during working or non-working hours, is prohibited and will subject the employee to immediate discharge.

B) Any employee who uses, possesses, or is under the influence of alcohol or controlled substance, whether legal or illegal, while on Company or client premises, including parking lots and vehicles, or while on Company business, during working or non-working hours is subject to discharge.

C) It is the responsibility of each employee to promptly notify his or her supervisor of the use of any prescribed medication which may affect judgment, performance, behavior, or safety. When an employee does not comply with this requirement, a physician’s prescription will not be an acceptable excuse for the use or possession of a controlled substance and the employee will be subject to immediate discharge.

D) Any employee convicted of violating any criminal drug statute which violation occurred on Company or client premises, including parking lots and vehicles, or while on Company business, during working hours or under circumstances that adversely affect job performance, or our Company or client’s reputation, will be subject to immediate discharge.

POLICY IMPLEMENTATION

As we notified you a couple of weeks ago with your paycheck, this “new” Post-Accident Drug And Alcohol Testing Policy goes into effect immediately upon receipt of this policy notice.

SPECIAL CONDITIONS

1) All post-accident injuries requiring outside medical attention, plus all lost-time injuries after enter date will require the injured employee(s) or other employees involved with the accident or injury, to take an “immediate” drug test.

2) This drug test will be at no cost to you, our employee. This test will be conducted by our Company’s designated physician or medical provider.

3) You, our employee, will be required to sign a consent form for the testing and release of the test results to our company.

4) Any employee refusing or failing to cooperate will be subject to immediate discharge.

5) Any employee testing positive for alcohol or controlled substances as a result of our “Post-Accident Drug And Alcohol Testing Policy” will be terminated.

6) In addition, our Company goes on record that we will cooperate fully with all legal law enforcement authorities.

Our company encourages ALL EMPLOYEES with Drug and Alcohol problems to seek professional assistance before they come to our attention and any of the above actions become necessary.

Company Post-Accident Drug & Alcohol Testing Policy

Employee Acknowledgment Sheet

I,______, have today read the above company-wide “Post-Accident Drug And Alcohol Testing Policy,” and I understand it and agree to abide by it.

( )...... English Version ( )...... Spanish Version

EMPLOYEE SIGNATURE: ______

DATE: ______

SUPERVISOR OR WITNESS: ______

VERIFIED DATE: ______

Company-Wide “Post-Accident” Drug & Alcohol Testing Policy

Consent and Release

I,______, hereby voluntarily provide a (urine sample) (blood sample) and understand and agree that said sample(s) will be subject to testing for the presence of drugs, alcohol, and controlled substances, and further authorize and agree that the results of the tests will be given to (Organization name).

I understand and agree that (Organization name) may use the results of such tests for decisions related to my employment, my continued employment, or disciplinary actions.

I understand that no one other than (Organization name) will receive the results of the tests without written consent from me.

______

Employee Signature Date

______

Witness Date

The signing of this form will be required for employment and re-employment determinations, and for post-accident evaluations and/or testing when considered necessary by the Company, at its exclusive discretion.