Appendix III Reasonable Suspicion Drug Testing -- Documentation Checklist Behavioral: Clumsy, uncoordinated? Unsteady gait/stumbling? Yes No Yes No Drowsy, sleepy, Tremors, shakes? lethargic? Yes No Yes No Suspicious, paranoid? Agitated, anxious, Yes No restless? Hyperactive, fidgety? Yes No Yes No Hostile, belligerent? Inappropriate, uninhibited Yes No behavior? Irritable, moody? Yes No Yes No Frequent use of mints, mouthwash, Depressed, withdrawn? eye drops? Yes No Yes No Appearance: Dilated (large) pupils? Flushed complexion? ☐Yes ☐No ☐Yes ☐No Excessive sweating? Constricted (pinpoint) pupils? ☐Yes ☐No ☐Yes ☐No Bloodshot eyes? Unfocused, blank stare? ☐Yes ☐No ☐Yes ☐No Tearing/watering eyes? Disheveled clothing/unkempt appearance? ☐Yes ☐No ☐Yes ☐No Speech: Slurred or Rapid, pressured? ☐Yes ☐No ☐Yes ☐No Incoherent? Excessively talkative? ☐Yes ☐No ☐Yes ☐No Exaggerated Nonsensical? enunciation? ☐Yes ☐No ☐Yes ☐No Cursing, inappropriate speech? Loud, boisterous? ☐Yes ☐No ☐Yes ☐No
Appendix III Reasonable Suspicion Drug Testing -- Documentation Checklist Behavioral: Unsteady gait/stumbling? Yes No Drowsy, sleepy, lethargic? Yes No Agitated, anxious, restless? Yes No Hostile, belligerent? Yes No Irritable, moody? Yes No Depressed, withdrawn? Yes No Clumsy, uncoordinated? Yes No Tremors, shakes? Yes No Suspicious, paranoid? Yes No Hyperactive, fidgety? Yes No Inappropriate, uninhibited behavior? Yes No Frequent use of mints, mouthwash, eye drops? Yes No Appearance: Flushed complexion? ☐Yes ☐No Excessive sweating? ☐Yes ☐No Bloodshot eyes? ☐Yes ☐No Tearing/watering eyes? ☐Yes ☐No Dilated (large) pupils? ☐Yes ☐No Constricted (pinpoint) pupils? ☐Yes ☐No Unfocused, blank stare? ☐Yes ☐No Disheveled clothing/unkempt appearance? ☐Yes ☐No Speech: Slurred or ☐Yes ☐No Incoherent? ☐Yes ☐No Exaggerated enunciation? ☐Yes ☐No Loud, boisterous? ☐Yes ☐No Rapid, pressured? ☐Yes ☐No Excessively talkative? ☐Yes ☐No Nonsensical? ☐Yes ☐No Cursing, inappropriate speech? ☐Yes ☐No
Drug_Testing_Policy_Template_v2016.docx