Drug and Alcohol Records Request

Form Template

The Drug and Alcohol Records Request form can be utilized by companies that are hiring individuals subject to workplace drug and alcohol testing under 49 CFR Part 40 for the Federally regulated transportation industry.

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Created by: Team GoCanvas
Language: English
Country: United States of America

The form collects in-depth information concerning drug and alcohol records to flag substance abuse problems, drug abuse problems, alcohol abuse problems, and the failure of a drug test by an employee that is subject to testing under federal law.

Alcohol testing and drug testing are federally mandated procedures to ensure that individuals operating motor vehicles in such a way as being subject to federal oversight (truck drivers, bus drivers, etc.) do not suffer from a substance use disorder. In order to obtain records that may otherwise be protected by privacy laws, this consent form allows a previous employer, or substance abuse professional, to minimize the chance that a driver engaging in alcohol or drug abuse is able to operate a vehicle commercially without being drug-free, avoiding alcohol misuse, and/or having successfully completed substance abuse treatment,

Features
  • Signature Capture
  • Conditional Fields
  • Submission Editing
  • Reference Data
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Platforms
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Integrations
  • Quickbooks
  • Salesforce
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