Drug-Free Workplace Survey
To receive information on how Industrial Screen can assist you with your drug-free workplace program please answer the following questions:
How many employees would be covered in your program?
Number of Locations?
Yes No Are you interested in testing for alcohol as well as illegal drugs?
Yes No Are you currently testing for drugs or alcohol?
Yes No Do you currently have a written policy?
Yes No Do you require a pre-employment physical exam?
Yes No Do you have any employees who fall under D.O.T. regulations?
Yes No Do you need assistance with your safety program?
Are you currently aware of unusual problems with:
Yes No Absenteeism?
Yes No Work Related Injuries?
Yes No Employee Benefits Claims Experience?
Yes No Productivity?
Yes No Theft?
Yes No Isolated or general attitude problems?
Company Name
Contact Name
Email Address