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M <br />Employee Name: <br />Date: <br />City of Eugene <br />Drug & Alcohol Test Request Form <br />DOT (CDL/FTA Operators) <br />DRUG TESTS <br />■ <br />❑ <br />Pre-employment <br />❑ <br />Pre-employment <br />❑ <br />Random <br />❑ <br />Random <br />❑ <br />Post Accident <br />❑ <br />Post Accident <br />❑ <br />Reasonable Suspicion <br />❑ <br />Reasonable Suspicion <br />❑ <br />Return to Duty <br />❑ <br />Return to Duty <br />❑ <br />Follow up <br />❑ <br />Follow up <br />Non D 0 T <br />DRUG TESTS <br />❑ Reasonable Suspicion <br />❑ Follow up <br />Special Instructions <br />❑ Reasonable Suspicion <br />City of Eugene Drug & Alcohol Test Request 612612006 <br />