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Drug/Alcohol Testing Release Form <br />Pre Hire <br />Release form for obtaining urine samples for drug screening and permission <br />to furnish the results to the company. <br />For Cause <br />Release form for obtaining urine samples for drug screening and permission <br />to furnish the results to the company. <br />Release form for obtaining NHTSA-approved evidential breath alcohol test <br />and permission to furnish the results to the company. <br />Post Incident <br />Release form for obtaining test samples for drug and alcohol screening <br />following any incident requiring medical care. <br />I hereby authorize Skyline Plastering, Inc., its physicians or agents, to take the <br />indicated sample from me to use for the purposes indicated above. I understand <br />why these samples are being requested and I give permission for the results to be <br />released to the company and to my employer (if different). <br />I further release and hold harmless the owners, the company and its contractors <br />from any consequences arising out of the drug and/or alcohol test or results <br />therefrom. <br />Name (please print) <br />Signature (required) <br />Street City <br />Social Security Number <br />Date <br />State Zip <br />Phone Number ��(with areacode) <br />............... ��� <br />Witness <br />Date <br />Employer Occupation <br />