This form is used when there is reasonable suspicion that an employee at work is unfit for duty; the employee appears to be in violation of the Drug and Alcohol-free Workplace Policy due to the use of alcohol or drugs. The employee’s supervisor or manager who is observing the behavior, along with another supervisor/manager as a witness, if possible, must complete this checklist.
Reasonable suspicion exists when an employee exhibits one or more of the observable behaviors on the list including, but not limited to, the odor of alcoholic beverages or other intoxicants, marked confusion or disorientation, slurred speech, erratic behavior or the employee is involved in an accident on the job.
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