<html> <head> <title>Rule 55:05:05:06 Medical information form.</title> <META NAME="Keywords" Content="Administrative Rules 55:05:05:06"> <META NAME="Description" Content="Administrative Rules 55:05:05:06 Medical information form."> <meta name=Generator content="Microsoft Office HTML Filter 2.0"> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Originator content="Microsoft Word 10"> <style> <!-- --> </style> </head> <body lang=EN-US> <div> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>55:05:05:06.&nbsp;&nbsp;Medical information form.</b> Before the drug screening, an employee shall complete a confidential medical information form upon which the employee discloses prescription medicines or over-the-counter products, if any, that were taken by the employee before the drug screening. This form shall contain the employee's name, social security number, and position number and must be signed and dated by the employee and the collection site observer. This form shall be transmitted with the specimen to the designated laboratory.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 17 SDR 25, effective August 19, 1990.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b>SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23-3-69">23-3-69(4).</A></p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Law Implemented:</b>SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23-3-65">23-3-65.</A></p> </div> </body> </html>