Acknowledgment of Receipt of the City of Pomona Substance Abuse Policy 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name in the 'Employee's Name' field. This identifies you as the individual acknowledging receipt of the policy.
3. Next, fill in your 'Department' to specify where you work within the City of Pomona.
4. Read through the acknowledgment statement carefully. Once you understand and agree to comply with the Substance Abuse Policy, proceed to sign in the 'Employee's Signature' field.
5. Enter today's date in the 'Date' field to document when you acknowledged receipt of this policy.
6. If applicable, for employees under eighteen, complete the section regarding drug and/or alcohol screening authorization by providing your child's name and obtaining a parent's signature along with the date.

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