Alcohol & Drugs Policy Violation Referral Form

As of May 1st, 2015, the Boilermaker Contractors' Association of Alberta has assumed the alcohol & drug referral process for Boilermakers, please refer to their website to submit a referral for a Boilermaker.

For union locals 254 and 424, please use ECAA's A&D Policy Violation Referral Form instead.

For assistance please contact Lynne Harder or Joe McFadyen at CLR 800-450-7204, or Shelley Gallant at Homewood Health - TPCM 780-493-0725. You may also fill out the ADP Contact Form.



. .


Referring Organization Contact Information

Project/Dispatch Information

Please attach copy of the Dispatch Slip & A&D Test Results if applicable & available

You may upload a maximum of two PDF documents, for multi-documents submissions please combine your documents into a single file before uploading.

Personal contact information of worker being referred

Do you have a personal phone and address? Yes


Contractor/Union: additional comments relevant to the case management of this file:

Please enter the characters you see: