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Development, Unemployment Insurance (DWD/UI) of a conditional offer of work that required a drug test and the offer was rescinded due to:

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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