Notification and Consent Form for Drug and Alcohol Testing for Minnesota Employers

Form/Letter
Drugs & Alcohol
HR Compliance

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(Minnesota Statute §13.04, Subd. 2)

I acknowledge that I have seen the (COMPANY NAME) Pre-employment/Employment Drug and Alcohol Testing Policy. I hereby consent to undergo drug and alcohol testing pursuant to said policy, and I authorize the (COMPANY NAME) through its agents and employees to collect a breath and/or urine and/or blood sample from me for that purpose.

I understand that the procedure employed in this process will ensure the integrity of the sample and is designed to comply with medicolegal requirements.

I understand that the results of this drug testing may be discussed with and/or made available to the (COMPANY NAME). I further understand that the results of this testing may affect my job offer as described in the policy.

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