DA Form 5019 R – Fill Out and Use This PDF

The DA Form 5019-R is a crucial document under the Department of the Army Drug-Free Federal Workplace Program, specifying the conditions of employment for civilian positions identified as critical. It outlines the necessity for selected or current employees to undergo random drug testing as a mandate for their employment continuity in such positions. To understand more about filling out this form and ensuring compliance with its conditions, click the button below.

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What Is DA Form 5019 R?

The DA 5019 R is an Army form used to maintain a drug-free federal workplace. It informs civilian employees and job applicants that certain positions require random drug testing as a condition of employment.

The form covers the key rules of the Drug-Free Federal Workplace Program. It explains required drug testing procedures, what happens if an employee tests positive, and how test results are kept confidential. See also our Drug-Free Workplace Certification page for related Army compliance forms.

Employees who do not meet these conditions may face reassignment or separation from service. The Employee Assistance Program (EAP) is available to help employees with drug-related concerns. Both the employee and supervisor must sign the form to confirm receipt of the notice.

Question	Answer
Form Name	Da Form 5019 R
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	da form 5019 fillable, form da 5019, da5019, da form 5019

How to Edit Da Form 5019 R Online for Free

Use the steps below to review and complete this Army form for the Drug-Free Federal Workplace Program. This document is required for civilian employees and job applicants in sensitive Army positions. It confirms your acknowledgment that random drug testing is a condition of your continued employment. FormsPal provides the PDF at no cost.

Form Structure and Contents

The form is one page and covers the following areas:

Employee name, position title, and organizational unit
A written statement of drug testing conditions and requirements
Signature and date lines for both the employee and supervisor
Guidance on the Employee Assistance Program (EAP) for confidential support

How to Fill Out the Form

Open this Army PDF using the button above.
Enter your name, job title, and organizational information at the top.
Read all conditions on the form carefully before signing.
Sign and date the form to confirm your agreement to random drug testing.
Return the completed form to your supervisor or HR office.
Keep a signed copy of the form for your own records.

After Signing the Form

Signing confirms your agreement to random drug testing as a condition of your job. If you refuse to sign, your supervisor will note this refusal in writing. Testing positive or refusing to test may lead to reassignment or removal from your position. The Employee Assistance Program (EAP) offers confidential support to employees with drug-related concerns.

When Is This Form Required?

This form applies to Army civilian employees in positions identified as sensitive or critical. HR offices issue the form during the hiring process or when a position is reclassified. The employee must sign before starting or continuing in the role. Army positions requiring this form may include roles in law enforcement, intelligence, and other sensitive job series defined by Army HR policy.

Frequently Asked Questions

Who must sign this form?

Civilian employees and applicants for sensitive or critical Army positions must sign. This includes roles involving national security information or public safety responsibilities.

What happens if I refuse to sign?

Your supervisor records the refusal in writing. Refusing to sign does not waive the drug testing requirement. You may face reassignment or removal from your position if you do not comply with testing.

How long does the form stay on file?

The form remains in your personnel file for the duration of your employment in that position. A new form may be required if you transfer to a different critical role.

Related Army and Employment Forms

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