Da form 2624-2025

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  1. Click ‘Get Form’ to open DA Form 2624 in the editor.
  2. Begin by filling out the 'Submitting Unit' section, including the laboratory conducting drug testing and batch number. Ensure all details are accurate for proper identification.
  3. Enter the 'Date Specimen Collected' using the format YYYY-MM-DD. This is crucial for tracking purposes.
  4. Complete the 'Specimen Number' and 'Complete SSN' fields accurately. The SSN must be the full number of the individual from whom the sample was obtained.
  5. Indicate the 'Test Basis' and provide any necessary 'Test Information'. If applicable, mark whether a prescreen was conducted.
  6. In the 'Chain of Custody' section, document each transfer of custody with signatures and dates to maintain accountability throughout the process.

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How many copies of DD Form 2624 are shipped with a box of samples? Only one original DD Form 2624 is required for each box of samples. Additional copies are not necessary.
DD Form 2624, Specimen Custody Document - Drug Testing
UPC must place original DD Form 2624 in a sealed envelope (retaining one copy) and affix the envelope to the sealed shipping container. k. UPC must wrap container with brown mailing paper or place container(s) in a larger outer container (DD Form 2624 will remain affixed to specimen box inside).
Once the interior waterproof container(s) with absorbent(s) are sealed, do the following: (1) Enclose one copy of DD Form 2624 (1D version only) in a waterproof mailer and insert mailer into shipping container box.
a. The UPC shall conduct urinalysis screenings at least four times a month using the Navy Drug Screening Program (NDSP) computer to randomly select between 15 and 40 percent of the command personnel each month.

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The original DD Form 2624 must be shipped with urinalysis samples in a secure manner. The form sandwiched between cardboard sheets and urinalysis samples should be kept in a plastic bag. Both should then be shipped in a padded box to prevent any damage or contamination.
You must use this form to authorize the IRS to contact a third party on your behalf or to revoke that authorization.

da form 2624