ATLANTA POLICE DEPARTMENT

CONSENT FOR HAIR SAMPLES AND

BODILY FLUIDS TO BE TAKEN

I hereby consent to be transported to Grady Hospital

where samples of my hair and bodily fluids will be taken. I fully understand that these hair and bodily fluid samples are to be used against me in a court of law and I am in agreement to give these hair samples for further use in this particular investigation. No threats, promises or rewards have been stated or implied or offered to me to induce or force me to sign this consent form.
I can/cannot read and write the English language and I fully understand my Constitutional rights.

I have read/had read to me this consent form for my hair and bodily fluid samples to be taken and I fully understand this form.
I understand that I am a suspect in a case that occurred on the day of in Fulton/Dekalb County State of George. The name of the victim in this case is being listed under incident # Cr # date of offense being on the day of .
Signature _______________________________________________
Sex:	Race:	DOB:
Date:	Time:
Witness:	Witness:
Witness:
Hair Sample Extracted by:
Bodily Fluid Extracted by:
This	Day Of:	Time:

APD FORM 310 - revised 6/29/00

ATLANTA POLICE DEPARTMENT

VWarnic

2000-09-11

Atlanta Police Department