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Volunteer Applicant’s Drug Screening Consent Form I understand that Salem Regional Medical Center requires drug testing as a part of its selection process for volunteers.. Physician’s Telephone Number: I hereby certify that the information contained in this application is correct to the best of my knowledge and understand that falsification or omission in this application in any detail is grounds for disqualification from further consideration or for dismissal from volunteering at the time CRMC discovers the omission and falsification..