Please also note that this and all other drug screening, driving record and state release authorization forms are available in a PDF format file to our  Automated Employment Screening  Clients, which may be e-mailed to the applicants and easily completed online.

CONSENT FOR PRE-EMPLOYMENT, RANDOM, OR REASONABLE SUSPICION DRUG TEST SCREEN AND RELEASE
COVENANT NOT TO SUE AND INDEMNITY AGREEMENT

I hereby CONSENT to allow (medical center) to take a specimen of my hair, urine, or blood and submit it for a pre-employment, random, or reasonable suspicion drug test screen.

I FURTHER CONSENT to allow the laboratory testing service to make the results of such screen available to the prospective or current employer, Company XYZ.

In consideration for such services being rendered on my behalf, I hereby RELEASE the laboratory testing service, its officers, agents, and employees, from any and all claims which I might otherwise have due to such results being made so available.

I hereby CONSENT NOT TO FILE ANY ACTION at law or in equity against Company XYZ, the laboratory testing service, their respective officers, agents or employees in connection with the results of such screen being made so available, and

I hereby agree to INDEMNIFY and SAVE HARMLESS Company XYZ, the laboratory testing service, their respective officers, agents, and employees from all damages, expenses, reasonable attorney’s fees, and costs of court which they or any of them may suffer or incur, jointly or severally, due to the results of such screen being made so available.

SIGNED this ___________day of _____________, 20___.