Consent to Student Drug and Alcohol Testing

In order to comply with health care industry partners’ and/or clinical agencies’ requirements, the College of Health Sciences requires that drug and alcohol testing will be conducted in accordance with Substance Abuse and Mental Health Services Administration (SAMHSA) guidelines and as outlined in the CHS 314.0 Student Drug and Alcohol Testing Policy for all students enrolled or participating in clinical courses, experiences or internships involving the direct delivery of patient care services. Safety in the delivery of care to patient/client populations is the basis for drug and alcohol testing required by industry partners and/or clinical agencies. In addition to policy CHS 314.0, industry partners/clinical agencies may have further requirements to obtain access to their facilities for experience.

Please read the following statements which outline potential additional requirements for clinical experience. I understand that:

1. My eligibility to participate in clinical experiences may require I submit to additional industry partner/clinical affiliate policies and procedures for compliance with drug and alcohol testing.
2. I must report any and all changes in physical and medical status due to taking prescription or non prescription medications that may inhibit my ability to participate in clinical experience without risk to patients, staff and/or myself to the program director or designee.
3. I may be required to obtain physician clearance to return to clinic after resolution of any physical and/or medical status changes that inhibit my ability to participate in clinical experience without risk to patients, staff and/or myself.
4. Failure to adhere to the Boise State University College of Health Sciences Student Drug and Alcohol Testing Policy, CHS 314.0, including the immediate report of physical and/or medical status changes which may inhibit my ability to participate in clinic without risk to patients, staff, and/or myself may result in my immediate dismissal from the program in which I am enrolled.
5. Failure to adhere to any portion of the CHS 314.0 or industry partner/clinical affiliate policies and procedures may also eliminate my eligibility to apply and/or enroll in any other clinically based programs offered by Boise State University.

I have received and read the Boise State University College of Health Sciences Student Drug and Alcohol Testing policy, CHS 314.0.

I agree to adhere to all requirements of the policy; as well as, the policies and procedures of industry partners/clinical affiliates.