CLINICAL/FieldWork AFFILIATE RANDOM DRUG SCREENING ANALYSIS
NOTIFICATION TO STUDENTS
Please be advised that students enrolled in the following Health and Behavioral Sciences programs may be required by an agency to undergo and pass a drug screening analysis in order to be eligible for placement in a clinical or fieldwork facility. Students who are assigned to clinical or fieldwork experiences at the facilities may be required to undergo and pass random drug screening analysis in order to remain at that facility. Students who either fail to pass, or refuse to submit to, a drug screening analysis will be deemed ineligible for clinical placement, which may affect their status in the program. If you have any questions pertaining to this policy, please contact the Office of the Assistant Dean of Academic Affairs, Division of Health and Social Sciences.
Programs in which Students may be subject to Drug Screening Analysis
Criminal Justice Early Childhood Education Human Services Massage Therapy and Bodywork Nursing - Associate Degree Nursing - Practical Nursing Physical Fitness Physical Therapist Assistant Respiratory Care
By my signature, I acknowledge that I have been provided with notification that clinical or fieldwork facilities may require me to undergo and pass a drug screening analysis. I am aware if I do not pass, or if I refuse to submit to, a drug screening analysis I will be ineligible to participate in the clinical or fieldwork component of my program.
Student name - PRINTED: