Drug Attestation Form - First Rate

First-Rate Caregivers Health
3500 Depauw Blvd, Suite 10806
Indianapolis, IN 46268

Drug Attestation Statement
I, [Employee/Applicant Name], hereby attest to the following:

1. I acknowledge that First-Rate Caregivers Health maintains a drug-free workplace policy and that I am required to comply with all related policies and procedures.
2. I affirm that I am not currently using any illegal or non-prescribed controlled substances.
3. I understand that the use, possession, distribution, or sale of illegal drugs is strictly prohibited while on company property, during work hours, or while representing the company in any capacity.
4. I agree to submit to drug testing as required by company policy, including pre-employment, random, reasonable suspicion, and post-incident testing.
5. I understand that refusal to submit to drug testing or a positive test result may result in disciplinary action, up to and including termination of employment.
6. I acknowledge that if I am taking legally prescribed medications that may affect my ability to safely perform my duties, it is my responsibility to notify appropriate company personnel as outlined in company policy.

Employee Certification
By signing below, I certify that the information provided in this attestation is true and accurate. I understand that providing false or misleading information may result in disciplinary action.