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A positive test result must include a copy of our Positive/ Refused Drug/ Alcohol Test Report DR-500-013 completed by the Medical Review Officer/Breath Alcohol Technician. When completed mail or fax this form and any required attachments to Suspensions Department of Licensing PO Box 9030 Olympia WA 98507-9030 Fax 360 570-7826 Driver name Last First Middle Initial Driver license number Date of birth Employer/ Motor carrier/ Consortium name Last 4 digits of Social Security number Used for identif ...

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What are 3 noticeable symptoms a person with higher levels of alcohol intoxication may have?

BAC greater than 0.3 percent: Delusions and hallucinations. Severe difficulty speaking. Severe dizziness. Severe deficits in coordination and psychomotor skills. Potential hypothermia. Potential coma (usually BAC greater than 0.4 percent, loss of consciousness, lack of defensive reflexes, respiratory failure).

What are the 3 stages of intoxication?

Reduced Muscle Coordination (BAC = 0.09 to 0.25 percent) \u2022 Loss of judgment. ... Confusion (BAC = 0.18 to 0.30 percent) \u2022 Confused\u2014might not know where they are or what they are saying. ... Stupor (BAC = 0.25 to 0.49 percent) \u2022 Can barely move. ... Coma (BAC = 0.35 to 0.50 percent) \u2022 Unconscious.

What are the levels of alcohol intoxication?

What do the results mean? Sober: 0.0 percent BAC. Legally intoxicated: .08 percent BAC. Very impaired: . 08\u20130.40 percent BAC. At this blood alcohol level, you may have difficulty walking and speaking. ... At risk for serious complications: Above . 40 percent BAC.

What are the 4 stages of intoxication?

Reduced Awareness, Information Processing, and Visual Acuity. Stages of Intoxication. Reduced Muscle Coordination (BAC = 0.09 to 0.25 percent) Confusion (BAC = 0.18 to 0.30 percent) Stupor (BAC = 0.25 to 0.49 percent) Coma (BAC = 0.35 to 0.50 percent) Death (BAC = 0.50 + percent)

What are 5 factors that determine intoxication?

Factors that Affect Intoxication Food. Always eat before drinking, especially foods high in protein. ... Strength of Drink. Stronger drinks will result in a higher BAC. ... Mood. Mood can affect the way one reacts to alcohol. ... Rate of Consumption. ... Functional Tolerance. ... Medications. ... Illness. ... Fatigue.

alcohol intoxication report format

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What are the 5 stages of being drunk?

Some people say there are 5 stages of intoxication: jocose, verbose, bellicose, lachrymose, and comatose. Others add grandiose, morose, and adios!

What are the seven 7 stages of intoxication?

There are seven stages of alcohol intoxication. Sobriety or low-level intoxication. A person is sober or low-level intoxicated if they have consumed one or fewer alcoholic drinks per hour. ... Euphoria. ... Excitement. ... Confusion. ... Stupor. ... Coma. ... Death.

What is the last stage of intoxication?

Stage 6: Coma Respiration and circulation are severely depressed, motor response and reflexes are markedly decreased, and the person's body temperature drops. The person who has reached stage six of alcohol intoxication is at risk of death.

Are there 5 stages of intoxication?

Some people say there are 5 stages of intoxication: jocose, verbose, bellicose, lachrymose, and comatose. Others add grandiose, morose, and adios! Let's take a closer look.

What are the three signs of intoxication?

Drowsiness, vomiting, and rapid drinking are likewise regarded as signs of intoxication. All of these signs may be considered on their own merits, or in concurrence with other signs, to judge whether or not a person is intoxicated.

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