Consent to Drug Testing
I, _____________________________, understand that
I agree to provide any specimens needed to conduct the drug test. I understand that if I refuse to undergo drug screening,
I have taken the following drugs or substances within the last 96 hours:
I hereby ( ) consent ( ) refuse to consent to undergo the drug test(s). I authorize any physician, laboratory, hospital, or medical professional retained by
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I have read and understood this consent form, and I sign without any coercion or duress by any individual or institution.
City, State, ZIP Code:_______________________________________________________________
Signature of parent/guardian:______________________________Date:_______________________
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