Cg 719p 2026

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The document is a U.S. Coast Guard Periodic Drug Testing Form, which outlines the requirements and procedures for drug testing under Title 46 CFR 16.220. It includes sections for applicant consent, laboratory information, and medical review officer details. The form specifies that drug tests are mandatory for certain transactions, lists the substances tested, and emphasizes the responsibility of the applicant for test costs. It also provides options for periodic, random, or pre-employment testing and includes a privacy act statement regarding the use of personal information.

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Click ‘Get Form’ to open the cg 719p 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, address, city, state, and zip code where your drug test will be conducted.
In Section III: Medical Review Officer, indicate the date the specimen was collected and check either 'NEGATIVE' or provide details for any non-negative results. Complete all required fields accurately.
Finally, ensure that all sections are filled out completely before saving or exporting your document for submission.

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