"Substance Free Workplace Policy Acknowledgment Form" - Rhode Island

Substance Free Workplace Policy Acknowledgment Form is a legal document that was released by the Rhode Island Department of Administration - a government authority operating within Rhode Island.

Form Details:

  • Released on December 6, 2019;
  • The latest edition currently provided by the Rhode Island Department of Administration;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Rhode Island Department of Administration.

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Download "Substance Free Workplace Policy Acknowledgment Form" - Rhode Island

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State of Rhode Island
Substance Free Workplace Policy
Acknowledgment Form
As an employee with the State of Rhode Island, I hereby acknowledge
that I have read and understand the State’s
Substance Free Workplace
Policy. I understand that if I violate the
Substance Free Workplace Policy
as stipulated in the General Procedures for Compliance, I will be subject
to discipline up to an including termination. I further understand that it
is a requirement by law that an employee notify their employing agency
in writing of a conviction for a violation of any federal or state criminal
drug statute no later than five (5) days after such conviction, and the
failure to do so will be subject to discipline, up to and including
termination.
_______________________________________________________________
Printed name
_______________________________________________________________
Signature
______________________
Date
URL to the State of Rhode Island’s
Substance Free Workplace Policy:
https://rigov-policies.s3.amazonaws.com/Substance_Free_Workplace_Policy_FINAL_9-17-19.pdf
Issued: 12.06.2019
State of Rhode Island
Substance Free Workplace Policy
Acknowledgment Form
As an employee with the State of Rhode Island, I hereby acknowledge
that I have read and understand the State’s
Substance Free Workplace
Policy. I understand that if I violate the
Substance Free Workplace Policy
as stipulated in the General Procedures for Compliance, I will be subject
to discipline up to an including termination. I further understand that it
is a requirement by law that an employee notify their employing agency
in writing of a conviction for a violation of any federal or state criminal
drug statute no later than five (5) days after such conviction, and the
failure to do so will be subject to discipline, up to and including
termination.
_______________________________________________________________
Printed name
_______________________________________________________________
Signature
______________________
Date
URL to the State of Rhode Island’s
Substance Free Workplace Policy:
https://rigov-policies.s3.amazonaws.com/Substance_Free_Workplace_Policy_FINAL_9-17-19.pdf
Issued: 12.06.2019