403.19-E3 - Drug & Alcohol Program and Pre-Employment Testing Written Consent to Share Information Form

I understand that the district will check and perform queries of my drug and alcohol testing results prior to my employment in any position which requires the use of a commercial driver’s license. I further understand the district will check and perform queries of my testing results annually and is required to report any drug and alcohol violations of this policy to the FMCSA Clearinghouse.

I understand that I am not required to consent to the query of the FMCSA Clearinghouse or the district sharing of drug and alcohol testing information with past, present or future employers of the FMCSA Clearinghouse; but that without my consent I understand I will be prohibited from performing safety sensitive functions, including driving a commercial motor vehicle, as required by FMCSA’s drug and alcohol program regulations.

I hereby give my consent to the district to perform queries of the FMCSA Clearinghouse and share my drug and alcohol testing results with past, present, and future employers, as well as the FMCSA Clearinghouse.