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
Denise Woo-Seymour, Supervisory Personnel Analyst; dseymour@admin.nv.gov or (775) 684-0149
| 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 |
| Authorization for Release of Confidential Information |
DOC |
PDF |
7/2019 |
| Required Referral Memo |
DOC1 |
|
7/2019 |