Physical Examination and
Drug Screening Consent Form:
I hereby give my consent to a physical examination, including, but not limited to, the collection of a blood, urine, or breath sample to be submitted for an alcohol, drug, and controlled substance, or any combination thereof, abuse screening test. Further, I hereby constent to the release of the test results to those Company officials who make employment decisions for the Company. I understand that any positive results from such test, like any other pre-employment investigation, which indicates my inability to satisfactorily perform the job for which I am applying may preclude my employment. Further, I understand that my failure to execute this voluntary consent will result in my not being further considered for employment. By signing in the box below, I am signing my consent to this release.