SOP 104.58-att-11: Withdrawal of Employment Offer for Refusal to Test_Failure to Remain or Appear for Pre-Employment Drug Test

SOP 104.58
Attachment 11

8/19/20

SAMPLE LETTER
Withdrawal of Employment Offer For
Refusal to Test/Failure to Remain or Appear

For Pre-Employment Drug Test

Date

Selectee's Name
Address
City, State, Zip Code

Dear [Name of Selectee]:

On ( INSERT THE DATE THE SELECTEE WAS OFFERED EMPLOYMENT ) you were offered
the position of ( INSERT TITLE OF POSITION OFFERED) at (INSERT NAME OF
FACILITY) . This employment offer was contingent upon passing a drug test.

Choose One:

- You were notified on ( INSERT THE DATE ) that an on-site drug test would be

immediately administered and you failed to remain for the on-site test.

- On ( INSERT THE DATE) , you refused to submit to a drug test.

- You were to report to a collection site no later than the close of business on (INSERT THE

DATE) , but failed to do so.

- Your name was listed as having a prior drug test result

Therefore, the offer of employment at (INSERT NAME OF FACILITY) has been withdrawn.

Sincerely,

[Signature]
[Name and Title of Appointing Authority]

CC: CHRM Drug Test Coordinator

Retention Schedule: Upon completion, this form shall be retained for two (2) calendar years in the Interview/Selection
File.