Adopted: January 1995
Revised: June 2015

 

Download 406.3.4.2.2P - Post-Accident Testing Procedure for Employees Required to have a CDL

 

Every employee in a position which requires the employee to hold a commercial driver’s license shall complete this form. 

 

          I understand that federal regulations require drivers to provide a urine sample to be tested for use of controlled substances as soon as possible, but not later than 32 hours, after a reportable accident in which the driver of the commercial motor vehicle receives a citation under state or local law for a moving traffic violation arising out of the accident or if the accident involves the loss of human life.

 

          I understand that in order for me to locate the nearest collection site where a urine sample can be taken, I can contact MEDTOX Laboratories at 651-636-7466 or at 1-800-832-3244, 24 hours a day, seven days a week.

 

      _____________________________________________________________   

                                        Employee’s Name (please print)

	X

 

 

 

      _____________________________________________________________    ____________

                                               Employee’s Signature                                                     Date

 

 

Procedure/406.3.4.2.2P/6-01-15

 

 

 

 

INDEPENDENT SCHOOL DISTRICT 196

Rosemount-Apple Valley-Eagan Public Schools

Educating our students to reach their full potential

 

Series Number   406.3.4.2.2P     Adopted January 1995  Revised          June 2015                                    

 

Title              Post-Accident Testing Procedure for Employees Required to have a CDL 

 

Every employee in a position which requires the employee to hold a commercial driver’s license shall complete this form. 

 

          I understand that federal regulations require drivers to provide a urine sample to be tested for use of controlled substances as soon as possible, but not later than 32 hours, after a reportable accident in which the driver of the commercial motor vehicle receives a citation under state or local law for a moving traffic violation arising out of the accident or if the accident involves the loss of human life.

 

          I understand that in order for me to locate the nearest collection site where a urine sample can be taken, I can contact MEDTOX Laboratories at 651-636-7466 or at 1-800-832-3244, 24 hours a day, seven days a week.

 

      _____________________________________________________________   

                                        Employee’s Name (please print)

	X

 

 

 

      _____________________________________________________________    ____________

                                               Employee’s Signature                                                     Date