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Alcohol/Drug Test Consent Form Mobile App

Use this simple alcohol and drug testing consent form app to register any belief that the employee is under the influence of alcohol or a controlled substance for the state of Nevada. The employee can sign the for for a drug test and alcohol test via a blood test. All signatures will be captured in the app.

  • Lendlease
  • The Cooperative
  • PG&E
  • oxy
  • Red Bull
  • Mirvac

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Take a peek inside the Alcohol/Drug Test Consent Form Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

  • {{data.title}}

Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico statictext

    EMPLOYER: If applicable, state objective facts giving rise to the belief that the employee is und...

  • Ico multiline

    Objective Facts

  • Ico statictext

  • Ico statictext

    I,

  • Ico textbox

    Name

  • Ico statictext

    pursuant to a request by my appointing authority or as a condition of employment with the State...

  • Ico textbox

    Department

  • Ico statictext

    hereby give my consent to and authorize the State and the testing laboratory designated by the St...

  • Ico checkbox

    Urine

  • Ico checkbox

    Blood

  • Ico checkbox

    Breath

  • Ico statictext

    as specified by statute and regulation.

  • Ico statictext

    I give my consent to release the results of the test(s) and other related medical information fro...

  • Ico statictext

    The appointing authority may request proof that I am taking a controlled substance as directed p...

  • Ico signature

    Applicant/Employee Signature

  • Ico date

    Date

  • Ico signature

    Supervisor’s Signature (if employee refuses to sign)

  • Ico date

    Date

  • Ico signature

    Witness’ Signature (if employee refuses to sign)

  • Ico date

    Date

  • ...and More!

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