Attachment C "Employee Notification of Adulterated Test Results" - Florida

What Is Attachment C?

This is a legal form that was released by the Florida Department of Juvenile Justice - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • The latest edition provided by the Florida Department of Juvenile Justice;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Attachment C by clicking the link below or browse more documents and templates provided by the Florida Department of Juvenile Justice.

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Download Attachment C "Employee Notification of Adulterated Test Results" - Florida

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FLORIDA DEPARTMENT OF JUVENILE JUSTICE
POLICY AND PROCEDURES
ATTACHMENT C EMPLOYEE NOTIFICATION OF ADULTERATED TEST RESULTS
CONFIDENTIAL
CERTIFIED MAIL, RETURN RECEIPT REQUESTED
PLACE LETTER ON DEPARTMENT LETTERHEAD
Today’s Date
Inside Address
Dear
:
This letter is to notify you that we have received the results of the drug test you underwent as a
condition of employment with the Department, and the results were consistent with a specimen,
which had been adulterated.
As a result of this adulterated test result, you will no longer be considered for employment as a
with this Department.
If you feel that this confirmed test result is inaccurate, the following appeal procedure is available.
• Within 180 days after receipt of this notification, you may have a portion of your original
specimen retested, at your expense. You must contact the laboratory that conducted the test to
initiate a retest of the specimen.
• The specimen retest must be performed by the same laboratory or by another laboratory that is
also licensed and approved by the Agency for Health Care Administration. The laboratory must
retest the specimen using standards equal to those used by the first laboratory.
• If you choose another qualified laboratory for the specimen retest, the first laboratory is
responsible for the transfer of the portion of the specimen to be retested, as well as the integrity
of the chain of custody during the transfer.
Sincerely,
Regional Director/Equivalent Level Administrator
Cc:
Office of Inspector General
Office of the General Counsel
Bureau of Human Resources
FLORIDA DEPARTMENT OF JUVENILE JUSTICE
POLICY AND PROCEDURES
ATTACHMENT C EMPLOYEE NOTIFICATION OF ADULTERATED TEST RESULTS
CONFIDENTIAL
CERTIFIED MAIL, RETURN RECEIPT REQUESTED
PLACE LETTER ON DEPARTMENT LETTERHEAD
Today’s Date
Inside Address
Dear
:
This letter is to notify you that we have received the results of the drug test you underwent as a
condition of employment with the Department, and the results were consistent with a specimen,
which had been adulterated.
As a result of this adulterated test result, you will no longer be considered for employment as a
with this Department.
If you feel that this confirmed test result is inaccurate, the following appeal procedure is available.
• Within 180 days after receipt of this notification, you may have a portion of your original
specimen retested, at your expense. You must contact the laboratory that conducted the test to
initiate a retest of the specimen.
• The specimen retest must be performed by the same laboratory or by another laboratory that is
also licensed and approved by the Agency for Health Care Administration. The laboratory must
retest the specimen using standards equal to those used by the first laboratory.
• If you choose another qualified laboratory for the specimen retest, the first laboratory is
responsible for the transfer of the portion of the specimen to be retested, as well as the integrity
of the chain of custody during the transfer.
Sincerely,
Regional Director/Equivalent Level Administrator
Cc:
Office of Inspector General
Office of the General Counsel
Bureau of Human Resources