<p> FORM 11/01/13 TOOL TYPE LAST REVIEWED ALL DUNSMORE GEOGRAPHY SOURCE: WEARING LLP </p><p>DRUG/ALCOHOL TESTING POLICY FORM</p><p>BENEFITS Drug and/or alcohol testing in the workplace is complex. Although intoxicated workers pose a safety risk to themselves and others, overly broad testing programs may intrude on their right to privacy. As a result, the courts have set strict rules for testing programs. So it’s critical that you comply with these rules when creating a testing policy and program for your workplace.</p><p>HOW TO USE THE TOOL</p><p>Use this form, created by lawyers at Dunsmore Wearing LLP, to implement a drug/alcohol testing policy in your workplace that covers certain key areas. </p><p>OTHER RESOURCES:</p><p>Recorded Webinar: Irving Pulp: What This Supreme Court Decision Means for Your Alcohol & Drug Testing Program</p><p>Drugs & Alcohol Testing, Part 1: What Are the Legal Limits on Testing Policies?</p><p>T H I S TOOL A ND H UNDR E DS M OR E AVA I L A B L E I N T H E OHS TOOL B OX AT www.ohsinsider.com . Templates and tools from OHS Insider are provided for members of our service. Members may use this document as is or as a starting point to customize their own documents. OHS Insider assumes no responsibility for the effectiveness or legality of any of its online templates or tools. Always consult your legal counsel and management before implementing any new policies or procedures. Drugs & Alcohol Testing, Part 2: How to Create an Enforceable Testing Policy</p><p>Model Post-Incident Drug and/or Alcohol Testing Procedures Checklist for Reasonable Cause Testing for Drugs and/or Alcohol</p><p>T H I S TOOL A ND H UNDR E DS M OR E AVA I L A B L E I N T H E OHS TOOL B OX AT www.ohsinsider.com . Templates and tools from OHS Insider are provided for members of our service. Members may use this document as is or as a starting point to customize their own documents. OHS Insider assumes no responsibility for the effectiveness or legality of any of its online templates or tools. Always consult your legal counsel and management before implementing any new policies or procedures. DRUG/ALCOHOL TESTING POLICY FORM</p><p>1. Where will the policy be kept?______</p><p>2. How will the policy be available to employees? Intranet Handout Policy book</p><p>3. Is the Company going to provide this policy to all potential employees? Yes No If so, how?______</p><p>4. Who will be responsible for ensuring uniform application and discipline?______</p><p>5. Which senior managers will be involved?______</p><p>6. What training will the HR department receive?______</p><p>7. Is any special training of sales staff required?______</p><p>8. What training will supervisors receive respecting their judgment of fitness for duty and safety issues?______</p><p>9. How will a broad definition of “on duty” be applied?______</p><p>10. What procedure will the Company follow to determine a safety sensitive position?______</p><p>T H I S TOOL A ND H UNDR E DS M OR E AVA I L A B L E I N T H E OHS TOOL B OX AT www.ohsinsider.com . Templates and tools from OHS Insider are provided for members of our service. Members may use this document as is or as a starting point to customize their own documents. OHS Insider assumes no responsibility for the effectiveness or legality of any of its online templates or tools. Always consult your legal counsel and management before implementing any new policies or procedures. 11. How will new jobs be added to the list of safety sensitive positions?______</p><p>12. What effort will be made to train employees about alcohol use, particularly in the 24 hours prior to work? Should an information campaign be created and implemented?______</p><p>13. Should supervisors in safety sensitive areas be required to do a sobriety check before each shift?______</p><p>14. How will the Company promote the Employee Assistance Program and encourage self-identification?______</p><p>15. Which qualified substance abuse professionals the Company will use?______</p><p>16. What post-accident protocol exists for ensuring proper reaction by supervisors and quick testing?______</p><p>17. What’s the protocol for contacting appropriate Company representatives?______</p><p>18. What instructions will be given about suspension pending investigation?______</p><p>19. What instructions will be given about note-making?______</p><p>20. What instructions will be given about custody of items?______</p><p>21. What instructions are there about when to call the police?______22. Who’s responsible for contacting the Medical Review Officer?______</p><p>T H I S TOOL A ND H UNDR E DS M OR E AVA I L A B L E I N T H E OHS TOOL B OX AT www.ohsinsider.com . Templates and tools from OHS Insider are provided for members of our service. Members may use this document as is or as a starting point to customize their own documents. OHS Insider assumes no responsibility for the effectiveness or legality of any of its online templates or tools. Always consult your legal counsel and management before implementing any new policies or procedures. ______</p><p>23. What is the policy on searches, such as of lockers and personal bags? How clearly has this policy been published? Does it bear repeating?______</p><p>24. Is there a protocol for removing employees from work? How will the Company ensure the safety of an inebriated employee?______</p><p>25. What protocol exists for addressing refusals to co-operate in testing? If the employee is being taken for an off-site test, what agreement is there with the tester on how to act?______</p><p>26. Will the Medical Review Officer also be the Assessor for return to work? Yes No Will he also be the qualified substance abuse professional? Yes No</p><p>27. How will the Company maintain confidential records and ensure confidentiality of the tests?______</p><p>28. Is the Company going to require vendors and contractors who come on its premises to comply with the testing policy, too?______</p><p>T H I S TOOL A ND H UNDR E DS M OR E AVA I L A B L E I N T H E OHS TOOL B OX AT www.ohsinsider.com . Templates and tools from OHS Insider are provided for members of our service. Members may use this document as is or as a starting point to customize their own documents. OHS Insider assumes no responsibility for the effectiveness or legality of any of its online templates or tools. Always consult your legal counsel and management before implementing any new policies or procedures. </p>