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Click ‘Get Form’ to open the drug screen collection form in the editor.
Begin by filling out the Employer Information section. Enter the Company/Collection Site, Address, Phone, Postal Code, State, City, and Fax. Ensure that the Picture ID is verified and note down the Donor’s ID Number.
Next, complete the Donor Information section. Fill in the Donor’s Last Name, First Name, Phone Number, and Date of Birth. The donor must then read and sign the consent statement to confirm their agreement.
Proceed to Collection Information. Indicate the Reason for Test (e.g., Pre-Employment, Random) and record the Kit Expiration Date/Lot Number. Check if the Specimen Temperature is within range (90-100F) and note any comments.
Finally, complete the Initial Test Results section by marking whether results are Negative or if Further Testing is Needed. The Collector/Tester must sign and date this section to certify accuracy.
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Bring the following information with you when visiting a collection site for an employment drug test: Labcorp chain of custody form, Web COC donor registration form/number, or the laboratory testing request form from a health care professional. Photo ID (e.g., drivers license, employee identification badge)
How do you become a drug screen collector?
To become qualified as a collector, you must be knowledgeable about Part 40 regulations, the current DOT Specimen Collection Procedures Guidelines, and DOT agency regulations applicable to the employers for whom you will perform collections, and you must keep current on any changes to these materials.
What is a drug screen form?
A drug test consent form is the document you must present to an employee or prospective employee in advance to test for illegal drugs and alcohol. When an individual signs the form, it allows a healthcare worker to obtain a sample from them and a lab to share those results with you.
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Related links
I. Employer: III. Drug Testing Data: IV. Alcohol Testing Data:
U.S. DEPARTMENT OF TRANSPORTATION DRUG AND ALCOHOL TESTING MIS DATA COLLECTION FORM. Calendar Year Covered by this Report: I. Employer
Missing/Incorrect Reason for Test. F. Missing/Incorrect Drug Tests to be Performed. G. Missing/Incorrect Collection Site Address, Collector Phone No. and Fax
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