My Drug Test

MedTox Laboratories, Inc

On Site Screening Custody Form

Collection Site: Community Hospital Occupational Health, GJ, CO

Donor Consent: I certify that I provided my specimen to the collector…

Date 10/28/2009          Time 14:28 __am  X pm

X Pre-employment __Random __Reasonable Suspicion __Return to Duty __Follow-up  __Post Accident  __Other

Specimen temperature within range (90-100 F/32-38 C): Yes

Test Results: Negative

Donor Comments: Drug paranoia apparently runs deep in Grand Junction. Pre-employment screenings are as common as the empty alcohol and tobacco containers littering the streets. This test was conducted for the city Parks and Recreation department and was taken 52 days p.m.i.

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