Can this form be signed electronically?

Yes. Electronic signatures are generally valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted. Ensure the method documents intent, attribution, and retention. Some narrowly defined exceptions for certain court and testamentary documents apply.

Do I need a notary or witness?

Most employer drug-testing consent forms do not require notarization. Check state-specific rules or union agreements; certain states or contract clauses may require witness or notarization for particular releases.

What if the employee refuses to sign?

Treat refusal according to your written policy. For safety-sensitive positions, refusal may be grounds for disciplinary action if policy was previously disclosed; ensure consistent, documented enforcement to reduce legal risk.

How long must results and applications be kept?

Retain test records per applicable statutes and policies: IRS three-year baseline if payroll-related, HIPAA six years for protected health information (45 CFR §164.530(j)), and I-9 related rules where applicable.

Can test results be shared with third parties?

Share only on a need-to-know basis and under lawful authority. For healthcare-related results, handle as PHI under HIPAA; obtain required authorizations before broader disclosure.

What steps preserve chain-of-custody?

Record collector identity, specimen IDs, date/time, transport details, and laboratory accession numbers. Missing or inconsistent chain-of-custody entries can make results inadmissible or unusable.

Electronic Signature
Templates
HR
Employee Drug and Alcohol Application

Employee Drug and Alcohol Application

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

EMPLOYEE DRUG AND ALCOHOL APPLICATION

Personal Information

Full legal name Date of birth Current address

Phone

Email

Position Information

Position applied for / Job title Department Reporting manager

Anticipated start date: Proposed salary/wage:

Employment History (Most recent first)

Employer 1

Company name Job title

From: To:

Primary responsibilities (brief) Reason for leaving

Employer 2

Company name Job title

From: To:

Primary responsibilities (brief) Reason for leaving

Education

Highest degree or certificate Institution Graduation date

References

Reference 1

Reference 2

Reference 3

Legal Disclosures and Acknowledgements

At-Will Employment: I understand that submission of this application does not create any employment contract. If employed, I acknowledge that employment with the company is at-will and may be terminated by either party at any time with or without cause or notice, except as may be expressly provided in a written agreement signed by an authorized company representative.

Equal Opportunity: The company provides equal employment opportunity to all employees and applicants without regard to protected characteristics as defined by applicable law. Decisions are made on the basis of qualifications, merit and business need.

Drug and Alcohol Testing Consent

As a condition of consideration for employment and, if employed, as a condition of continued employment, I understand the company requires drug and alcohol testing in accordance with company policy. Such testing may include but is not limited to urinalysis, breath alcohol testing, blood testing, oral fluid testing, and hair testing. I consent to these tests under the conditions described below and authorize the release of test results to the company and its designated agents.

Testing actions I consent to (check all that apply):

Pre-employment testing Random testing Reasonable suspicion testing Post-accident testing

I acknowledge that refusal to submit to testing, tampering with a specimen, or a confirmed positive result may result in withdrawal of an offer of employment or disciplinary action up to and including termination. I further acknowledge that test specimens will be handled and stored in accordance with applicable laws and company policy, and that confirmatory testing procedures are used prior to any adverse employment action.

Medical and Disclosure Questions

Have you ever tested positive for drugs or refused a drug/alcohol test at any employer within the past 5 years? Yes No

If yes, provide dates, employers, and explanation

Are you currently taking prescription medication that could affect test results or job performance? Yes No

If yes, list medication(s) and prescribing physician (privacy note: disclosure required only to the extent necessary for safety and testing interpretation)

Authorization and Release

By signing below I authorize the company, its agents and testing laboratory to collect specimens for drug and alcohol testing and to release the results of such tests to the company and its authorized representatives. I authorize my prior employers, references, physicians and medical facilities to provide information concerning my employment, drug/alcohol testing history, and medical conditions to the company or its agents. I release the company, testing laboratories, physicians, prior employers, and their agents from any liability arising from such disclosure and testing to the extent permitted by law.

I understand that the company may require a confirmatory test and that I will be informed of procedures to challenge or explain any positive result in accordance with company policy. I further understand that certain positions may require more stringent testing protocols and that compliance with medical privacy laws will be observed to the extent consistent with safety and policy implementation.

Applicant Certification

I certify that all information provided on this application is true, complete and correct to the best of my knowledge. I understand that any misrepresentation, falsification, or omission may result in denial of employment or immediate termination regardless of when discovered. I authorize the company to verify the information provided and to obtain job-related information about me.

Additional remarks (optional)

Applicant Printed Name:

By:

Date:

What the Employee Drug and Alcohol Application Is

An Employee Drug and Alcohol Application is an HR consent and information form used to authorize, document, and schedule drug and alcohol testing for applicants or employees. The form typically records consent to testing methods (urine, oral fluid, hair), disclosure of testing policy, acknowledgment of consequences for positive or refused tests, and chain-of-custody instructions for specimen handling. Employers use the application to demonstrate notice and to collect the data needed for compliance with company policy, collective bargaining agreements, and applicable federal or state testing rules.

Why employers use this application

A clear, signed application documents employee consent, streamlines testing logistics, and supports defensible workforce-safety decisions while preserving privacy and recordkeeping requirements.

Who completes and signs this application

The Employee Drug and Alcohol Application is completed by the individual being tested and managed by HR or safety teams.

Employers and HR teams responsible for safety-sensitive roles, staffing, and policy enforcement.
Applicants and current employees who are subject to pre-employment, post-accident, reasonable suspicion, or random testing.
Occupational health clinics or third-party testing vendors that collect specimens and report results to employers.

Supervisors, occupational health staff, or designated drug-testing administrators typically retain copies and manage next steps.

Step-by-step: filling and processing the application

Follow these sequential steps to complete the application and move the testing workflow forward without delay.

01

Review Policy: Read employer testing policy and any disclosure pages before signing.
02

Complete Fields: Fill all required personal and testing fields accurately.
03

Sign and Date: Sign using the required method (wet signature or permitted e-signature) and add the date.
04

Submit to HR/Vendor: Provide the completed form to the designated HR representative or testing provider.

Typical submission and testing flow

A standard workflow moves the signed application from the employee to the testing vendor, then to the employer with lab reporting and documentation.

Upload or Hand in: Employee submits form to HR or uploads to secure portal.
Specimen Collection: Testing vendor collects specimen following chain-of-custody procedures.
Lab Analysis: Laboratory performs analysis and returns results to the vendor or employer.
Result Review: Designated reviewer assesses results and applies company policy or follow-up steps.

How to set up the online testing workflow

Configure digital fields and routing so completed applications trigger specimen collection and result routing automatically.

Field	Configuration
Required Fields	Mark name, DOB, consent checkbox as required.
Signer Order	Set employee signs first, HR or clinician countersigns second.
Notifications	Enable email or SMS alerts to HR and vendor on submission.
Retention Policy	Configure automated archival per retention rules.

Digital signing and platform needs

Select a platform that supports secure upload, conditional fields, and robust audit trails.

File formats: PDF, DOCX supported
Integrations: Integrates with HRIS, NetSuite, Box
Authentication: Email, SMS, or advanced 2FA

Core components to include in a professional application

A complete application balances clear consent language, specimen handling instructions, and legal disclosures while minimizing ambiguous terms.

Clear Consent

Explicit authorization language stating the employee consents to the specified tests, including consequences for refusal; helpful for defensibility.

Test Types

List permitted specimen types (urine, oral fluid, hair) and the circumstances for each testing type to avoid later disputes.

Chain of Custody

Instructions and fields for collector name, date/time, and specimen ID to preserve laboratory admissibility and traceability.

Privacy Notice

Describe how test results will be used, stored, and who will have access to comply with state privacy and HIPAA where applicable.

Consequences

Define disciplinary or return-to-duty procedures, including any referral to employee assistance programs or mandatory retesting.

Acknowledgments

Signature and dated acknowledgment that the employee received policy details and understands their rights.

Security and privacy controls to include

Encryption: TLS 1.2/1.3; AES-256 at rest

Access Controls: Role-based access

Audit Trail: Timestamped event logs

HIPAA BAA: BAA available

Retention Settings: Configurable retention

Activity Logs: Detailed access history

Key legal and operational risks

Invalid Consent: Unenforceable if incomplete

Privacy Breach: HIPAA exposure risk

Chain Break: Lab evidence may be rejected

Discrimination Claim: Improper testing may prompt suit

Recordkeeping Failures: Violates retention rules

Regulatory Fines: Penalties for noncompliance

Common mistakes to avoid

Incomplete fields or missing signatures that delay testing and may invalidate consent.
Using ambiguous or outdated consent language that fails to meet state privacy or occupational requirements.
Failing to preserve chain-of-custody details during collection and transport, undermining laboratory results.
Storing results in insecure locations or sharing broadly, creating HIPAA or employment-privacy exposure.

Typical timelines and processing expectations

Timelines vary by test type and vendor; these are common expectations to plan around for collection, analysis, and retention.

Acknowledgment Delivery:

Provide employee copy at time of signing

Specimen Collection:

Collect within employer-specified timeframe (often same day)

Lab Turnaround:

Vendor reporting commonly within 1–3 business days

Record Retention:

Retain records per retention policy and legal requirements

Adverse Action Timing:

Allow time for confirmatory testing and employee response

Key milestones in the testing lifecycle

Numbered project milestones track from application through final disposition to keep stakeholders aligned.

01

Application Signed

Employee signs application and receives a copy.

02

Specimen Collected

Testing vendor collects specimen following chain-of-custody.

03

Preliminary Result

Lab returns initial screening result to vendor or employer.

04

Confirmatory Testing

Positive screens undergo confirmatory analysis before action.

Comparison of eSignature pricing and features

Baseline pricing and basic feature availability for common eSignature vendors. Confirm plan details with each provider for enterprise features and compliance add-ons.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies	Varies	Varies	Varies
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No
Envelope Cap	No envelope cap	100 envelopes/user/year	Varies	Varies	Varies

Frequently asked questions and troubleshooting

Answers to common operational and legal questions about completing, signing, and storing the Employee Drug and Alcohol Application.

Need help? Contact support

Can this form be signed electronically?
Yes. Electronic signatures are generally valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted. Ensure the method documents intent, attribution, and retention. Some narrowly defined exceptions for certain court and testamentary documents apply.
Do I need a notary or witness?
Most employer drug-testing consent forms do not require notarization. Check state-specific rules or union agreements; certain states or contract clauses may require witness or notarization for particular releases.
What if the employee refuses to sign?
Treat refusal according to your written policy. For safety-sensitive positions, refusal may be grounds for disciplinary action if policy was previously disclosed; ensure consistent, documented enforcement to reduce legal risk.
How long must results and applications be kept?
Retain test records per applicable statutes and policies: IRS three-year baseline if payroll-related, HIPAA six years for protected health information (45 CFR §164.530(j)), and I-9 related rules where applicable.
Can test results be shared with third parties?
Share only on a need-to-know basis and under lawful authority. For healthcare-related results, handle as PHI under HIPAA; obtain required authorizations before broader disclosure.
What steps preserve chain-of-custody?
Record collector identity, specimen IDs, date/time, transport details, and laboratory accession numbers. Missing or inconsistent chain-of-custody entries can make results inadmissible or unusable.

be ready to get more

Join over 28 million airSlate SignNow users

Sign Now