Pre - Employment Drug Testing - Employer Reported Refusal to Submit or Positive Result
Document Number: UCB-18102-E
Description: Use this form to notify the Department of Workforce Development, Unemployment Insurance (DWD/UI) of a conditional offer of work that required a drug test and the offer was rescinded due to:
- the individual refusing to submit to a drug test for the presence of controlled substances.
- a positive drug test result for the presence of a controlled substance.
Comments: This form can be filled out on the computer as a fillable pdf. It should be printed and signed, then mailed or faxed to Unemployment Insurance, P.O. Box 7905, Madison, WI 53707. The Fax Number is (608) 260-2506.
Content Contact: Benefit Operations Staff
Document Attachment: UCB-18102-E (Electronic Version - pdf/19 KB)
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