INFORMATION RELEASE AND AUTHORIZATION In order to determine whether a candidate is suitable for a position, it is necessary to thoroughly review a candidate’s complete employment background and references. All current and past employers may be contacted once a tentative offer of employment has been made or employment has been accepted. Many employers and references will not provide a candid response unless there is an authorization and release of liability statement. Please carefully review the following paragraphs and sign and date the form below. I, hereby authorize PharmaCare Services to contact any employer, law enforcement agency, state agency, institution or private information bureau that has any record or knowledge of my motor vehicle operation history, criminal history or employment-related history, in order to obtain or verify information on, but not limited to criminal, credit, driving, employment, and education. I hereby authorize past employers or affiliations to release any so acquired information to PharmaCare Services or its representatives. I hereby release PharmaCare Services, their officers, employees, and agents, from any and all liability arising from the results of any investigation and the preparation of any reports concerning myself or my background. I authorize the companies, schools, persons or entities given during the employment process, while employed, and during internal investigations, as references or past employers or affiliations to give any information regarding my employment, character, qualifications, certifications and licenses and hereby release said companies, schools, persons or entities from all liability for any damage for issuing this information. A favorable result may be a condition of employment or commencement of any employment duties where elements are job-related. A photographic copy of the authorization shall be as valid as the original. Permission is granted for information to be released by any state agency. I waive any provision impeding the release of this information, and agree to provide any information necessary for the release of this information above and beyond that provided on the employment application. I understand that there may be state and federal requirements as well as insurance and employment requirements that will require periodic checks of all the above-referenced sources. If employed, I further authorize periodic checks of all abovereferenced sources, as may be deemed necessary by employer. DRUG AND ALCOHOL TEST AUTHORIZATION FORM AND RELEASE The drug and alcohol abuse policy, called the SUBSTANCE ABUSE POLICY (or the "Policy"), of PharmaCare Services prohibits the presence of illicit substances in the systems of its employees while on the job. A confirmed, positive test is a violation of the Policy. I understand that I am required to take a drug and alcohol screening test: (1) as a condition of post-offer testing; (2) if the Company suspects use of drugs or alcohol; (3) following any accident or incident at work; (4) during medical examinations; (5) as a part of any investigations; (6) at the random discretion of the Company during the course of my employment. I further understand that this analysis will be conducted by a certified laboratory with all data to be held in confidence except as otherwise necessary to carry out the terms and objectives of this Policy. I understand that positive results of the test, in accordance with the Policy, is a direct violation of the Policy and may prohibit employment with the Company and, if already employed, is immediate grounds for corrective action, up to and including termination. I understand that it is my responsibility prior to the drug and alcohol testing to inform the laboratory and/or the Company of any medication, prescribed or non-prescribed, that I may be taking and/or have taken within the last 60 days prior to the testing. I CONSENT TO THE RELEASE OF THE RESULTS OF ANY DRUG OR ALCOHOL TEST TO AUTHORIZED REPRESENTATIVES OF THE COMPANY FOR APPROPRIATE REVIEW. I RELEASE AND AGREE TO HOLD HARMLESS THE COMPANY, ITS EMPLOYEES, OFFICERS, AND AGENTS FROM ANY AND ALL CLAIMS, DAMAGES, ACTIONS, DEMANDS, CAUSES OF ACTION, OR LIABILITY OF ANY KIND, INCLUDING BUT NOT LIMITED TO LIABILITY FOR NEGLIGENCE BASED UPON THE RESULTS OF ANY TEST CONDUCTED PURSUANT TO THE TERMS OF THE POLICY . DRUG AND ALCOHOL ABUSE POLICY I acknowledge that the policy of PharmaCare Services is to have a drug-free and alcohol-free environment. I consent freely and voluntarily to a drug and alcohol test under the circumstances described above along with all the terms and conditions of the substance abuse policy. I also understand that, although I may not agree with the Policy, failure to acknowledge the Policy with my signature below may prohibit my employment with PharmaCare Services or lead to corrective action, up to and including termination.