Application For Certification Of Drug-Free Workplace Premium Credit Program (Page 5 of 5) in pdf

Application For Certification Of Drug-Free Workplace Premium Credit Program Page 5

Supervisor Training Required for Certification:

(Code of Alabama, 1975, §25-5-337 (b))

_____

Participation of supervisors with the employees in the above education program.

AND

_____

Once a year, two hours of supervisor training on how to recognize signs of substance

abuse, how to document and collaborate signs of employee substance abuse, and how

to refer substance abusing employees to the proper treatment providers.

NOTE: Second half of supervisor training program may be completed within six

months after certification.

Confidentiality Required for Certification:

(Code of Alabama, 1975, §25-5-339)

_____

All information received through substance abuse testing is confidential, but may be

used or received in evidence, or obtained in discovery, or disclosed in any civil or

administrative proceeding when the information is relevant to the employer's defense,

e.g., a workers' compensation hearing.

NOTE: Employers should ensure that they have read and understand the Disclaimers of a

drug-free workplace program and the information on Maintenance and Revocation of

certification.

Notarization of Certified Drug-Free Workplace Program

______________________________

Employer Name

Officer/Owner Signature*

______________________________

Date

Title of Officer/Owner

Application must be signed by an officer or owner.

Sworn to and subscribed before me this __________ day of _____________20____.

____________________________________

Notary Public

My Commission Expires________________

Application For Certification Of Drug-Free Workplace Premium Credit Program Page 5