This easy-to-use form will help you satisfy 49 CFR §391.23(e) and §40.25 which require the prospective employer to obtain alcohol and drug testing information from a driver/applicant's previous employers.

Use J. J. Keller's Previous Employer Alcohol & Drug Test Information form if you keep confidential alcohol & drug records separate from other driver records, or if you are not required to obtain accident records from previous employers under section 391.23(d). This form covers:

• Driver/applicant's authorization to release information
• Employment verification and alcohol and drug test information (including previous tests, refusals, and rehabilitation).

Available in two formats: padded format, 8 1/2" W x 11" L, 50 forms per pad, or snap-out format, carbonless, 3-ply, 8 1/2" W x 11" L, detached.

Can be used in combination with the Request For Information From Previous Employer form for a complete Safety Performance History solution! Or consider the all-in-one Safety Performance History Records Request.

---

To view these forms and hundreds of other J. J. Keller forms, click here.