Template

Drug and Alcohol Testing Consent Form

by SafetyCulture

200+

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Use this form as consent for conducting Drug and Alcohol Testing

With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

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SafetyCulture

Free 1,000+ Workplace Checklists & Templates created by the SafetyCulture team.

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Drug and Alcohol Screening Consent Form

This Drug and Alcohol Screening Consent and Chain of Custody form helps workplaces collect informed consent and maintain clear custody of samples during testing. It captures donor information, company and contact details, consent declarations, and collector certification. Record device and batch details, dates, and initial results across multiple drug classes (e.g., THC, AMP, OPI, BZO). Includes prompts for medication disclosure and sample integrity to support compliance.

by Daniel Gray, from the Community

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Template

Burbank Group Alcohol and Drug Test Log

This Burbank Group Alcohol and Drug Test Log helps teams record workplace testing for alcohol and drugs. It captures preliminary declarations, induction and policy acknowledgments, medication details, and informed consent. The form supports alcohol breath testing and oral fluid drug screening across common panels including THC, cocaine, methamphetamine, MDMA, amphetamines, opiates, and benzodiazepines. Fields include test type and readings, notes for non negative markers, photos of results, and space for supervisor and site details. Use this log to standardize procedures, document chain of custody at site level, and strengthen health and safety compliance on construction projects.

by Frank Perconte, from the Community

10+

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Template

On-Site Drug and Alcohol Authorization Form

Use this on-site drug and alcohol testing authorization form to document employee consent following a post-accident or incident event. Capture test administrator and donor names, date and location, saliva drug test lot numbers and expiration dates, indicate if a second test is required, and note when additional laboratory testing is arranged. Include return-to-work date and time, and route completed results to Safety and Human Resources for recordkeeping. This customizable template supports incident response, HR documentation, and compliance with company policy; always consult your legal or HR advisor to confirm suitability for your workplace and jurisdiction.

by Josh McComas, from the Community

10+

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Template

Drug and Alcohol Permanent Screening Record

This template helps mining companies document permanent employee drug and alcohol tests. Capture test location, date, donor and collector details, medication declarations, breath alcohol device IDs and readings, and multi-panel drug screen outcomes (THC, COC, OPI, METH, AMP, BZO, OXY). Include consent acknowledgments, signatures, and follow-up requirements to ensure compliance with site policies and safety regulations. Use this record to standardize screening, support audits, and maintain a clear chain of custody.

by Kelly Jensen, from the Community

10+

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Template

Random Drug and Alcohol Test Checklist

This random drug and alcohol test checklist helps workplaces conduct compliant screenings and keep clear records. Capture test details including location, date, type of test and equipment used. Record employee identification, witness selection, and pre-screening questions on recent alcohol or drug use, medications, and timing. Document mouth swab screening as the primary sample, results, employee comments, and actions taken if positive. Include signatures from the employee and company representative to complete the audit trail.

by natalie cavanagh, from the Community

10+

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Random Drug and Alcohol Test

Use this random drug and alcohol test checklist to conduct fair, compliant workplace screening. The template guides safety officers through pre-screening questions on recent alcohol use, illicit drugs, medications, and oral intake; records testing equipment used (saliva swab and breath analysis), location, witness, and test numbers; captures employee awareness of policy and signatures; logs results and employee comments; and documents next actions such as referral to pathology, counseling, or dismissal. Intended as a starting point for site safety programs in construction and other high-risk environments.

by Martin Lawrie, from the Community

10+

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