Acknowledgment of Employer’s Drug and Alcohol Policy Template

Use our acknowledgment of employer's drug and alcohol policy template as a starting point to customize yours to fit your business.

Acknowledgment of Employer's Drug and Alcohol Policy Template

What are the Benefits of Using this Acknowledgment of Employer's Drug and Alcohol Policy Template?

  1. It Enhances Workplace Safety:

    Employee acknowledgment of the drug and alcohol policy reinforces a safer work environment by minimizing the risk of impaired performance due to substance use.

  2. It Reduces Legal Risks:

    Obtaining signed acknowledgments safeguards employers legally, demonstrating a commitment to a drug-free workplace and reducing potential legal liabilities.

  3. It Ensures Policy Consistency:

    Using this template ensures uniform communication of the policy, promoting fairness and equity among employees in upholding behavioral standards.

  4. It Fosters Productivity:

    Acknowledgment of the policy empowers employees to make responsible choices, cultivating accountability and professionalism that support a productive work culture.

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The Acknowledgment of Employer’s Drug and Alcohol Policy is a formal document that outlines an employee’s understanding and agreement to adhere to the company’s policies regarding drug and alcohol use in the workplace.

This acknowledgment ensures a clear understanding of the policy’s expectations and consequences. 

Customize this template to align with your organization’s specific policies and procedures.

Acknowledgment of Employer’s Drug and Alcohol Policy Template:

Employee Information:

– Employee Name: [Employee’s full name]

– Employee ID: [Employee’s identification number]

– Position/Title: [Employee’s job title]

– Date of Acknowledgment: [Date of signing the acknowledgment]

Policy Acknowledgment:

I, [Employee’s Name], acknowledge that I have received, read, and understood the Employer’s Drug and Alcohol Policy as outlined in the employee handbook. I agree to adhere to the terms and guidelines set forth in the policy while employed by [Company Name].

Policy Highlights:

  1. Prohibited Substances: I understand that the use, possession, sale, or distribution of illegal drugs, controlled substances, or alcohol is strictly prohibited on company premises, during work hours, or while representing the company.
  2. Impairment: I am aware that coming to work under the influence of drugs or alcohol is prohibited and poses a risk to my safety, the safety of my colleagues, and the quality of my work.
  3. Prescription Medications: I acknowledge that if I am using prescription medications that may impair my ability to perform my job safely, I am responsible for notifying my supervisor and HR department.
  4. Testing and Searches: I understand that the company may conduct drug and alcohol testing as required by law or in accordance with company policy. I agree to comply with such testing when requested.
  5. Consequences: I am aware that violation of the Drug and Alcohol Policy may result in disciplinary action, up to and including termination of employment.
  6. Confidentiality: I understand that any information related to drug and alcohol testing and policy violations will be treated confidentially.

Employee Signature:

By signing below, I acknowledge that I have read and understood the contents of the Employer’s Drug and Alcohol Policy and agree to comply with its terms.


Signature: _________________________

Date: ____________________________

Company Representative’s Signature:

I acknowledge that the above employee has received and understood the Employer’s Drug and Alcohol Policy.


Signature: _________________________

Date: ____________________________


The Acknowledgment of Employer’s Drug and Alcohol Policy Template provides a formal record of an employee’s understanding and agreement to adhere to the company’s policies.

By utilizing this template, organizations can promote a safe and productive work environment while maintaining clarity on expectations and consequences related to drug and alcohol use in the workplace.

Customize the template to align with your company’s policies and ensure compliance with relevant laws and regulations.

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