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Urine initial drug screen result form 2025

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The document is a Urine Initial Drug Screen Result Form used for collecting and documenting drug test results. It includes sections for donor information, collection site details, reasons for testing, specimen validity tests, preliminary drug test results, and collector certification. The form ensures proper identification of the donor and the integrity of the specimen during the testing process.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out the 'Completed by Collector or Employer Representative' section. Enter the collection site or company name, address, city, state, phone, and fax number.
Next, provide the donor's identification details including SSN, driver's license, or employee ID number. Ensure that the ID is verified by checking the appropriate box.
In the 'Reason for Test' section, select one of the options such as Pre Employment or Random by marking the corresponding checkbox.
Record the specimen temperature within four minutes and indicate if it falls within the acceptable range of 90º - 100ºF (32º - 38ºC).
Complete the 'Initial Test Results' section by marking results for each drug tested. Use the color chart provided for interpretation.
Finally, ensure that both collector and donor sign and date where indicated to certify completion of the form.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do I know if I passed my drug test?

Negative Result: This means no drugs were detected in your system. You have passed the test. A negative result is often accompanied by a brief explanation of what substances were tested for and the thresholds used. Positive Result: This indicates the presence of drugs.

How to read a drug screen results?

A positive drug test result is when ONE line appears in the Control Region (C) and NO line appears in the Test Region (T). A positive test result means that the drug concentration in the sample is greater than the designated cutoff level for a specific drug; additional confirmatory drug testing may be needed.

What is the initial drug screen?

Initial drug screens use the immunoassay method for analysis, which uses antibodies to detect drugs at the molecular level. Confirmatory or definitive tests either verify or refute the result of an initial screen.

How to fill out a drug test form?

There are four main elements to a drug test consent form. Step 1: Authorization. In the first section of the drug test consent form, your employee must authorize the laboratory or healthcare worker to take a specimen (hair, , blood, etc.) Step 2: Disclosure. Step 3: Release. Step 4: Signature.

Does a faint line on a drug test mean negative?

What Does a Faint Line on a Drug Test Mean? A faint line on a drug test may indicate that the person used a substance in the past, but theres not enough in their system to qualify as a positive. Faint lines on drug tests must count as negative results.

10 panel drug test form

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How to read a sample result?

Normal values are as follows: Color: Yellow (light/pale to dark/deep amber) Clarity/turbidity: Clear or cloudy. Odor: Aromatic. pH: 4.6-8 (average is 6) Specific gravity: 1.005-1.03 (in adults), 1.001-1.02 (in newborns) Glucose: Fresh specimen: Negative; 24-h specimen: 50-300 mg/day or 0.3-1.7 mmol/day. Ketones: None.

What is the difference between 80307 and 80320?

CPT definitive drug screen testing codes (80320-80377 and 83992) represent individual definitive drug tests which are billed separately. Screening by a broad-spectrum chromatographic procedure, which detects multiple drug classes, should be billed using code 80307.