PMP Limited Query Consent

Limited Query Consent
FMCSA Employer*
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I, {name}, hereby provide consent to {fmcsaEmployer} to conduct a limited query of the FMCSA Commercial Driver’s License Drug and Alcohol Clearinghouse to determine whether drug or alcohol violation information about me exists in the Clearinghouse.

The terms of consent are for an annual limited query commencing on {date} and are for the duration of my employment with {fmcsaEmployer}.

I understand that if the limited query conducted by {fmcsaEmployer} indicates that drug or alcohol violation information about me exists in the Clearinghouse, FMCSA will not disclose that information to {fmcsaEmployer} without first obtaining additional specific - electronic consent from me.

I further understand that if I refuse to provide consent for {fmcsaEmployer} to conduct a limited query of the Clearinghouse, {fmcsaEmployer} must prohibit me from performing safety-sensitive functions, including driving a commercial motor vehicle, as required by FMCSA’s drug and alcohol program regulations.
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