• Pre- Employment Urinalysis Notification

    The Federal Motor Carrier Safety Regulations, Section 391.103 - Pre-employment testing requirements, apply to driver applicants seeking a driving position with this company.

    391.103 Pre-employment testing requirements

    (a) A motor carrier shall require a driver applicant who the motor carrier intends to hire or use to be tested for the use of controlled substances as a prequalification condition. (b) A driver applicant shall submit to controlled substance testing as a prequalification

    (c) Prior to collection of a urine sample under sec 391.107 of this subpart, a driver applicant shall be notified that the sample will be tested for the presence of controlled substances.

    As a condition of my employment, I agree to the urine sample collection and controlled substance testing.

    I understand a positive test for controlled substances bases on the urinalysis test will medically disqualify me from the operation of a commercial motor vehicle with this company.

    The medical review officer will maintain the results of the urinalysis test. Negative and positive test will be reported to the company.

    My written authorization is required for the urinalysis test results to be given to other parties.

    I have read and understand the above conditions for the Pre-Employment Urinalysis Notification.

  • Clear
  •  / /
    Pick a Date
  •  
  • Should be Empty:
Jotform Logo
Now create your own Jotform - It's free!Create your own Jotform