PARENT/GUARDIAN CONSENT TO DRUG TEST OF A MINOR
My minor child has been selected to participate in the Greater Ozarks CAPS program (“GOCAPS”), which requires drug testing as a condition of enrollment/participation in the program. This annual test must be completed prior to the first day of class each year. The deadline for testing this school year is August 2022.
I, the undersigned parent/legal guardian of the minor child named below, do hereby authorize and consent to a urine drug screening test to be performed on my minor child. I understand that the drug test to be performed is a twelve panel screen, which tests for cocaine, amphetamines, barbiturates, benzodiazepines, marijuana, opiates, phencyclidine, propoxyphene, oxycodone, methamphetamine, methadone and MDMA. I understand that the results of the drug test will be reported to CoxHealth, Mercy Lebanon Communities and GOCAPS.
Should the results of a laboratory confirmation test indicate the presence of a drug or drugs in my student's test, I give permission for the GOCAPS coordinator to contact me (parent/legal guardian) to discuss the test results. I understand the Executive Director can offer and/or I may request the test results be reviewed by a Medical Review Officer (MRO) to determine if a legal medical explanation exists for the presence of a drug or drugs. If the MRO does not review test results, or if the MRO cannot verify a legitimate medical reason for the presence of a drug or drugs in the test result, the test will be deemed as positive. I further understand the decision of the MRO/GO CAPS will be final. I also understand that a positive test will result in my student being refused enrollment or dismissed from continuing participation in the GOCAPS program.