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Fitness For Duty Policy

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FITNESS FOR DUTY POLICY

Drugs and Alcohol

I. POLICY

II. DEFINITIONS

The following definitions pertain to this policy:

III. TESTING FOR DRUGS AND ALCOHOL.

IV. DISCIPLINARY RULES

V. EMPLOYEE ASSISTANCE PROGRAM

VI. SUBCONTRACTORS AND INVITEES

VII. COMPANY-SPONSORED EVENTS.

Alcohol may be served at Company-Sponsored Events with the prior approval of an officer of the Company. Employees attending such events are urged to make arrangements for an "alcohol-abstaining designated driver."



CONSENT FORM


        I agree to take a urine or blood or breath test to detect alcohol 
        or drugs.  I also agree that the report of the results of any such 
        test may be released to ABC Company, Inc.


        ____________________________    ____________________________________
        Witness                         Signature



        ____________________________________
        Date

        ____________________________________
        Time



PRESCRIPTION DRUG FORM


        To insure the safety of all personnel and equipment, the following 
        information is requested for the prescription drug or drugs or 
        over-the-counter drugs you now possess which may impair your 
        performance.  Efforts will be made to keep all information provided 
        herein strictly confidential.


       NAME _______________________________________________________________

       EMPLOYER ___________________________________________________________

       PRESCRIBING PHYSICIAN'S NAME _______________________________________

       CITY ________________________   TELEPHONE NUMBER____________________

       NAME OF DRUG _________________ PRESCRIPTION NUMBER _________________
 
       LENGTH OF TIME PRESCRIPTION WILL BE TAKEN  _________________________
        
       DATE PRESCRIBED ________________   

       DOES THE DRUG PRODUCE ANY SIDE EFFECTS:  Yes _____   No _____

       IF YES, DESCRIBE ___________________________________________________

       ____________________________________________________________________
                 
       ____________________________________________________________________


       I give my consent for the above named prescribing physician to answer 
       any questions about my use of the above drug. 



       ____________________________________
       Signature




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