Policy Statements > Alcohol and Drug Policy > Employee Acknowledgement Form

Employee Acknowledgement Form

I hereby acknowledge receipt of Power Tech Industries Alcohol and Drug Policy and Procedures. I have read and understand this policy and will abide by it as a condition of my employment. I understand that refusal to submit to any drug testing required by this policy or a positive test result is grounds for disciplinary action up to and including termination. Furthermore, I authorize the release of the test results to my employer, and/or on post-accident tests, the Company’s workers compensation insurance carrier and understand that refusal to release these results is grounds for disciplinary action up to and including termination.

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Employee Name:

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Employee Signature: Date:

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Witness Signature: Date: