Cg 719p form 2026

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The document is a U.S. Coast Guard Periodic Drug Testing Form (CG-719P) used to comply with drug testing requirements under Title 46 CFR 16.220. It outlines the process for applicants to submit drug test results, including consent, laboratory information, and medical review officer details. The form specifies that drug tests are required for certain transactions and must be conducted by accredited laboratories. It also includes privacy notices regarding the collection and use of personal information.

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Click ‘Get Form’ to open the cg 719p form in the editor.
Begin with Section I: Applicant Consent. Fill in your name, reference number (if applicable), social security number, and date. Ensure you sign the form to certify your consent.
Proceed to Section II: Name of SAMHSA Accredited Laboratory. Enter the laboratory's name, street address, city, state, and zip code.
In Section III: Medical Review Officer, input the date the specimen was collected. Check the appropriate box for the verified test results—negative, cancelled, or positive.
If applicable, complete the section for positive/adulterated/cancelled drug tests by providing details about the verification and MRO contact information.
Review all entered information for accuracy before saving or exporting your completed form.

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Versions	Form popularity	Fillable & printable
2017	4.8 Satisfied (140 Votes)
2014	4.3 Satisfied (69 Votes)
2004	4 Satisfied (31 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is a 5 panel drug test for the military?

A DOT 5 Panel testing for Marijuana, , Opiates, Phencyclidine, and Amphetamines. Signed by a certified Medical Review Officer (MRO) approved through AAMRO or MROCC. A negative result (if the results is a Negative Dilute) it will NOT be accepted.

Who can fill out form cg 719K?

A physician, physician assistant, or nurse practitioner who is licensed in the U.S. or a U.S. territory can fill out and record their findings on form CG-719K. You can also try walk-in clinics or places that do employment physicals.

What documents do you need for a drug test?

Bring the Important Documents If you do not have a drivers license, another form of government-issued ID will suffice, such as a passport or military ID. Most employers pay for drug testing of employees and potential employees, therefore, you likely dont have to worry about making a payment.

What is a cg 719B form?

APPLICATION FOR MERCHANT MARINER CREDENTIAL (FORM CG-719B) ------ Instructions ------ 1. . Applicants seeking a Merchant Mariner Credential (MMC), whether original, renewal, duplicate, raise of grade, or a new endorsement on a previously issued MMC and applicants requesting a Medical Certificate.