403.06E(3) - Drug & Alcohol Program Pre-Employment Testing Written Consent to Share Information

I, ( Name of Employee ), understand that as part of my employment in a position that requires a commercial driver’s license in the North Tama County Community School District, I grant consent for the District to conduct queries of the Federal Motor  Carrier Safety Administration (“FMCSA”) Commercial Driver’s License Drug and Alcohol Clearinghouse to  determine whether drug or alcohol violation information about me exists in the Clearinghouse. I further consent to  the District sharing information related to my drug and alcohol testing results with prior, current and future  employers, as well as the FMCSA Clearinghouse in accordance with state and federal laws. 

I understand that the District will check and perform queries of my drug and alcohol testing results prior to my  employment in any position which requires the use of a commercial driver’s license. I further understand the  District will check and perform queries of my testing results annually and is required to report any drug and alcohol  violations of this policy to the FMCSA Clearinghouse. 

I understand that I am not required to consent to the query of the FMCSA Clearinghouse or the District sharing of  drug and alcohol testing information with past, present or future employers or the FMCSA Clearinghouse; but that  without my consent I understand I will be prohibited from performing safety sensitive functions, including driving a  commercial motor vehicle, as required by FMCSA’s drug and alcohol program regulations. 

I hereby give my consent to the District to perform queries of the FMCSA Clearinghouse and share my drug and alcohol testing results with past, present and future employers, as well as the FMCSA Clearinghouse.  

 

__________________________________________________                ________________________
(Signature of Employee)                                                                                                             (Date)

 

 

I.C. Iowa Code                                      Description
Iowa Code § 124                                                Controlled Substances
Iowa Code § 279.8                                            Directors - General Rules - Bonds of Employees
Iowa Code § 321.375                            Motor Vehicles - Bus Drivers
Iowa Code § 730.5                                            Drug-Free Workplaces  

U.S.C. - United States Code                   Description
41 U.S.C. §§ 81                                                Public Contracts - Drug-Free Workplace
42 U.S.C. § 12101                                             Public Health - Equal Opportunity - Disabilities
49 U.S.C. §§ 5331                                             Transportation - Testing /Controlled Substances

C.F.R. - Code of Federal Regulations     Description
49 C.F.R. Pt. 382                                               Transportation - Controlled Substances and Alcohol Use Testing
49 C.F.R. Pt. 390                                               Transportation - Federal Motor Carrier Safety Regulations
49 C.F.R. Pt. 40                                                Transportation - Drug and Alcohol Testing Procedures

Cross References:  403.05  Substance-Free Workplace
                                          403.05-R(1)  Substance-Free Workplace - Regulation
                                          403.05-E(1)  Substance-Free Workplace - Notice to Employees
                                          409.02  Employee Leaves of Absence

Approved: 7/21/2025
Reviewed: 6/16/2025
Revised: 6/16/2025