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Fillable Printable Consent to Participation in Mandatory Student Drug Testing Program Form

Fillable Printable Consent to Participation in Mandatory Student Drug Testing Program Form

Consent to Participation in Mandatory Student Drug Testing Program Form

Consent to Participation in Mandatory Student Drug Testing Program Form

SEALY INDEPENDENT SCHOOL DISTRICT
Sealy High School
2372 Championship Dr. Phone: 979.885.3515
Sealy, TX 77474 www.sealyisd.com Fax: 979. 987.3398
Sealy ISD does not discriminate because of race, age, color, national origin, sex or disability.
Consent to Participation in
Mandatory Student Drug Testing Program
We have read and understand the policy governing Sealy ISDs Mandatory Drug
Testing Program. We understand that as a condition of participation in
extracurricular programs and a condition for parking and driving on school
premises at Sealy High School, the student named below must participate in the
drug testing program. By our signatures below, we authorize Sealy ISD to
conduct drug testing on any urine specimen/breathalyzer testing that the named
student will provide on the dates and times specified by the Sealy ISD School
officials.
We understand that at the time of test, we, at our own discretion, may provide a
copy of any medical prescription or doctors verification related to any medicines
the student may be taking. If we provide this information in a sealed envelope to
school personnel, we understand that the sealed envelope will be forwarded
unopened to the designated testing lab. We further understand that the lab will
be instructed to consider the students use of such medication to assure an
accurate outcome of the drug testing. The prescription drug information will not
be disclosed by the testing lab to any SISD school official.
________________________________ Male Female
Student Name:
________________________________
Student ID#:
______________________________________ _______________
Signature of Parent/Guardian: Date
______________________________________ _______________
Signature of Student: Date
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