Pre-Employment Authorization to Release of Information for Prior D.O.T. Drug and Alcohol Screening Results from Prior Employer
About this form
The Pre-Employment Authorization to Release of Information for Prior D.O.T. Drug and Alcohol Screening Results from Prior Employer is a legal document that allows a potential employer to access an applicant's drug and alcohol testing history from previous employers who are regulated by the Department of Transportation (D.O.T.). This authorization specifically targets an applicantâs eligibility to perform safety-sensitive functions and is essential for compliance in the transportation industry.
Key components of this form
- Applicant's personal information, including name and Social Security Number.
- Details of the previous employer, including contact person and address.
- Authorization language granting permission to release drug and alcohol testing records.
- Statement assuring the information will only be used to assess eligibility for safety-sensitive roles.
- Section for previous employer to confirm testing history and provide additional documentation if necessary.
When to use this document
This form is necessary when an applicant is seeking employment in a safety-sensitive position within a D.O.T.-regulated industry. It should be submitted when applying for jobs where previous drug and alcohol testing history is required to ensure compliance with federal regulations. Each previous employer from the last two years must be contacted with a separate authorization form to obtain the relevant information.
Who should use this form
- Job applicants seeking employment in D.O.T.-regulated positions.
- Employers needing to check an applicantâs drug and alcohol testing history.
- Previous employers who must disclose testing results as part of the hiring process.
Steps to complete this form
- Fill in your name and Social Security Number at the top of the form.
- Provide the details of the contact person at your previous employer, including their name and address.
- Sign and date the form to grant authorization.
- Ensure the previous employer checks the appropriate boxes regarding your drug and alcohol testing history.
- Submit a separate form for each D.O.T.-regulated employer you worked for in the past two years.
Is notarization required?
This form does not typically require notarization unless specified by local law. However, always confirm with your potential employer if additional verification is necessary.
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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.
Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.
Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.
If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.
We protect your documents and personal data by following strict security and privacy standards.
Common mistakes
- Failing to submit separate forms for each prior D.O.T. employer.
- Not signing or dating the authorization, which renders the form invalid.
- Providing incorrect or incomplete information about the previous employer.
Benefits of using this form online
- Convenient access to a legally vetted form that can be easily downloaded and completed.
- Editable formats allow applicants to fill in information accurately.
- Ensures compliance with D.O.T. regulations, reducing the risk of hiring delays.
