DFWP Program - Acknowledgment Form
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|DRUG FREE WORKPLACE PROGRAM |
|AKNOWLEDGEMENT FORM |
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|CDS Family & Behavioral Health Services, Inc. |
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|CDS Family & Behavioral Health Services, Inc. has established a Drug Free Workplace Program. This policy is implemented pursuant to |
|Florida Statute ‘440.101.et.seq., which provides that an applicant for employment or an employee who violates any portion of the Drug Free |
|Workplace Program will not be eligible for hire and will forfeit all eligibility for medical and indemnity benefits under the Drug Free |
|Workplace Act. Employees are prohibited from using drugs, or taking prescription medication without a prescription, on or off the |
|employer's premises. Employees are prohibited from drinking alcohol or being intoxicated while on the employer's premises. Employees are |
|also prohibited from possessing or transporting illegal drugs on the premises. Employees may only transport alcohol on the employer's |
|premises if part of the employee's job responsibilities. Possession of paraphernalia used in connection with the use of any drug is |
|evidence of violation of this rule. |
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|Drugs means alcohol, including distilled spirits, wine, malt beverages and intoxicating liquors, amphetamines, cannabinoids, cocaine, |
|phencyclidine (PCP), hallucinogens, methaqualone, opiates, barbiturates, benzodiazepines, synthetic narcotics, designer drugs or a |
|metabolite of any of these substances. Non-prescribed use of prescription medication is also prohibited except as outlined in the policy. |
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|As a part of our policy prohibiting drug or alcohol use, drug testing will be required. An employee violates the Drug Free Workplace |
|Program by testing positive in a confirmed test for drugs. Refusal to cooperate in the drug testing procedure is equivalent to testing |
|positive. |
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|It shall also be an independent violation of this rule to refuse search of one's purse, lunch box, locker, automobile, or other container |
|upon reasonable suspicion and on reasonable terms. |
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|Employees are required to report any drug related criminal charge brought against them, whether the result of on-duty or off-duty conduct. |
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|Any violation of this rule will result in discipline, up to and including discharge and possible forfeiture of workers' compensation |
|medical and indemnity benefits. |
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|Employee Signature | |Date |
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