As a condition to my employment at Roofmeadow Services, Inc, I agree to submit to a urine drug test, also knows as urinalysis. The purpose of this urinalysis is to determine the use of controlled substances in my body.
I understand that the results of this urinalysis, if confirmed positive, may remove me from consideration for employment at Roomeadow Services, Inc. A positive test indicates the presence of marijuana, cocaine, opiates, amphetamines, and/or phencyclidine.
For the sole purpose of this urinalysis, I authorize my employer’s Authorized Agents to collefct samples of my urine, and to use thse samples or to forward these samples to a testing laboratory chosen by Roofmeader Service, Inc. for analysis. I also authorized thse results to be reviewed by a Medixal Review Officer (MRO).
Further, I authorize my Employer’s Authorized Agents to release the results of this urinalysis, and any other related documentation, to Quest Diagnostis, and to Roofmeadow Services, Inc.’s agents and employees with a need-to-know.
I agree that a reproduced copy of this Consent and Release for Employment Drug Screening shall have the same force and effect as the original.
I further understand that if I am taking prescription drugs approved by a medical physician, I am encouraged to furnish said prescription to an agent of the testing laboratory prior to the collection of my urine sample.
I have carefully read the foregoing, and I fully understand its contents. I agree that my signing of this Consent and Release for Employment Drug Screening is voluntary, and that I have not been coerced into signing this document.
