Web consent freely and voluntarily to the company’s request for a specimen. Web further authorize and give full permission to have the company and/or its authorized agents and physicians to send the specimen or specimens so collected to a laboratory for a screening test for the presence of any prohibited substances under the policy, and for the laboratory or other testing facility to release any and all documentation relati. (ebt) blood test special procdures: Federal drug testing custody and control form. Bring the following information with you when visiting a collection site for an employment drug test: With this approach, all job candidates will receive drug testing prior to being hired. And i further authorize employment screening services, inc. Web authorization for examination or treatment auth pad ft cuc.pdf 3/18/09 9:56:47 am (patient must present authorization and photo id at the time of service.) authorization for examination or treatment patient name:___________________________________________________ social security. (usdot) drug test as required by 49 cfr part 655.41. As a condition of my employment at _______________________________________, i agree to submit to a urine drug test (also known as a urinalysis) and/or a breath alcohol test. I hereby release and hold harmless the company and its employees and agents from any liability whatsoever arising from this request to furnish my specimens and the testing of my specimens.
