URINE INITIAL DRUG SCREEN RESULT FORM Specimen ID Number STEP 1: COMPLETED BY COLLECTOR OR EMPLOYER REPRESENTATIVE COLLECTION SITE / COMPANY NAME ADDRESS SUITE CITY STATE PHONE POSTAL CODE FAX DONOR SSN, DRIVERS LICENSE or EMPLOYEE I 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'COLLECTION SITE / COMPANY NAME' section. Enter the name of the collection site, followed by the address, suite number, city, state, phone number, and fax number.
3. In the 'DONOR SSN, DRIVER’S LICENSE or EMPLOYEE I.D. NO.' field, input the appropriate identification for the donor. Ensure that this information is accurate for verification purposes.
4. Next, complete the 'DONOR NAME' section with the last and first names of the donor. This is crucial for identifying test results.
5. Select the reason for testing from options such as Pre Employment, Random, or Post Accident by checking the corresponding box.
6. Ensure to read and record the specimen temperature within four minutes. Mark whether it falls within the acceptable range of 90º - 100ºF (32º - 38ºC).

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