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Employee questionnaire regulated 2025

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The document is an Employee Questionnaire required by the Drug Enforcement Agency for individuals at Temple University who will have access to controlled substances. It includes questions regarding felony or misdemeanor convictions, use of narcotics without a prescription, and any history with DEA registration issues. The responses are confidential and part of the employment evaluation process.

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Click ‘Get Form’ to open it in the editor.
Begin by reading the introduction carefully. This section outlines the importance of providing accurate information and assures confidentiality.
Proceed to the first question regarding felony or misdemeanor convictions. Select 'Yes' or 'No' and provide details if applicable in the space provided.
For the second question, indicate your usage of narcotics or amphetamines in the past three years. Again, select 'Yes' or 'No' and elaborate if necessary.
The third question pertains to any DEA registration issues. Answer accordingly and provide details if you select 'Yes'.
Review the authorization statement at the bottom, ensuring you understand your rights regarding privacy and inquiries.
Finally, sign and date the form where indicated, ensuring all required fields are completed before submission.

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