Use of Alcohol or Drugs Forms


Use of Alcohol or Drugs Forms

If you would like more information, please contact Consultation & Accountability:

Carrie Hughes, Personnel Analyst; cphughes@admin.nv.gov or (775) 684-0111

Michelle Garton, Supervisory Personnel Analyst; mgarton@admin.nv.gov or (775) 684-0136

    Form Title  Word  PDF Revision Date
    Policy Statement - Alcohol/Drug Free Workplace and Acknowledgment  TS-58 TS-58 7/1998
    Report Form for Suspected Alcohol/Drug Impairment  TS-77 TS-77 12/2017
    Alcohol/Drug Consent Form  TS-76 TS-76 4/2016
    Non-DOT Breath Alcohol Test Request  NPD-79 NPD-79 10/2013    
    ComPsych Release of Information Form     DOC PDF 11/2011
    Required Referral Memo     DOC1