Substance Use Recovery and Workplace Safety Program Enrollment Form

Introduction
Employers who hire workers in substance use recovery use this form to enroll in the Substance Use Recovery and Workplace Safety Program. Brought to you by your local Alcohol Drug Addiction and Mental Health Services board (ADAMHS) and the Ohio Bureau of Workers' Compensation, this program will provide the following:

  • Reimbursement for pre-employment, random, confirmatory, reasonable suspicion, post-accident, and return-to-duty drug testing.
  • Training for managers/supervisors to better manage and retain workers in recovery.
  • A forum for employers, workers, and boards to share their success stories and learn from each other.

Required information

  • Policy number
  • Company name and DBA name
  • Company address, City, State, and ZIP code
  • County
  • Number of employees
  • Employer contact name, title, address, phone number and email for the program

If you have all the required information on hand, simply click the start button to begin.

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