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A Drug and Alcohol Testing Consent Form is utilized by employers to screen applicants and employees for substance use, including instances of reasonable suspicion. Drug testing regulations differ by state and industry, generally requiring employee consent. An employee's refusal to complete the consent form may result in termination. Typically, a first failed test must be confirmed by a second to eliminate false positives, and while employees can contest results, challenging two failed tests is often difficult. Pre-employment testing may also be mandated by some employers, who must inform applicants about the possibility of testing at the beginning of the hiring process.