
Random UA Form
READ THIS CAREFULLY! ! !
You have been selected for a random URINE ANALYSIS TEST!, also known as a UA. It does not necessarily mean that you have done anything to trigger this test. This test is done in accordance with the agreement that you signed when you started this program.
The specimen collection is supervised, which means a member of the same sex will be with you in the restroom observing.
Refusal to submit to a UA test or altering the test in any way will result in immediate termination.
If you are unable to provide a urine specimen within (1) hour, this will result in immediate termination.
You may drink fluids.
You may not leave the sight of the collector until a urine specimen has been collected.
If you choose to leave the sight of the collector, it will be considered a relapse.
Now is your opportunity, before you are tested, to admit to any drinking or using drugs. If you have relapsed, your best course of action is to admit it immediately. We understand how difficult it is to stay clean and sober and if you are honest, we will provide you with some assistance to help you get back on track. Residents who are truthful will be permitted to state his or her case, whereas a liar does not get that opportunity. Staff are workable with those who are honest. The important thing in recovery is to be honest. We do not always get recovery the first time. In either instance your contract with Trinity House is terminated and you must immediately leave the property; if you were honest and agree to going straight to a detox program, we can discuss holding your bed for 1-2wks while you are in detox. If you were not honest, you must leave the property and we will not hold your bed. You might be permitted to come back at a later date provided that there is an open bed, you have gone through a detox program, and have been sober for an additional 2wks, but this decision will be made by the house manager and will be up to their discretion.
After reading the above, do you have anything to declare concerning drinking any alcohol or using drugs.
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This section to be completed by Bright Hope Housing Staff.
