"I, the undersigned, hereby knowingly and voluntarily authorize and consent to the collection and testing
of specimens of my urine by a collection site and laboratory to be designated by Caravan Supply or its
designated agent, Employment Screening Services, Inc., for the purpose of drug testing."
"I authorize the collection site, laboratory and medical review officer (MRO) to disclose the results of my
drug tests to Employment Screening Services, Inc. and I further authorize Employment Screening
Services, Inc. to disclose the results to Caravan Supply."
"I acknowledge that the drug test results will be utilized by Caravan Supply to determine my eligibility
for employment or continued employment, therewith."
"I acknowledge that at the time of collection, a refusal to authorize the collection and testing of my urine
by the collection site and laboratory, or a refusal to authorize the above disclosure of the test results
will be treated as a positive drug test. I further acknowledge that a positive drug test will result in
disciplinary action up to and including denial of employment or termination, if hired."
"I further authorize the testing laboratory to disclose the results of my drug screen to Caravan Supply, or
its agents, Employment Screening Services, Inc. for a period of time not to exceed two years from the
date of my signature below."
"I acknowledge that I have the right to receive a copy of this authorization."
"I have read and understood the above Authorization & Consent in its entirety, and I agree that a copy of
this document is as valid as the original."