Under Connecticut law, no employer may require a prospective employee to submit to a urinalysis drug test as part of the employment application process unless: (1) the prospective employee is informed in writing at the time of application of the employer’s intent to conduct such a drug test; (2) such test is conducted in accordance with the requirements of Connecticut’s drug testing laws; and (3) the prospective employee is given a copy of any positive urinalysis drug test result.

The results of such test must be confidential and must not be disclosed by the employer or its employees to any person other than any employee to whom such disclosure is necessary.

In addition, although the Americans with Disabilities Act and Connecticut’s fair employment laws do not specifically prohibit drug testing, employers may want to limit drug tests until after a conditional offer of employment has been made.

The job offer may be conditioned upon the test results and the applicant should be informed that the offer will be withdrawn if the results are not acceptable.

By the attached sample form, the applicant consents to undergo a drug test and authorizes the testing facility to release the results to the employer.

The following form is only a sample that can be modified to meet an employer’s needs. 


I, ____________________________________________________(name), do hereby consent to undergo a drug/alcohol test, as required by ________________________________________________________ (employer).

Further, I authorize the hospital, clinic and/or testing facility to release to ____________________________________________________(employer) the results of such test and I release the hospital, clinic, and/or testing facility, its doctors, and medical personnel from liability from any release or use of this information.

Signature: ____________________________________________________

Date: __________________