Forms - CalHR
 

Substance Testing Forms

The forms you need depend on the testing authority - State, federal, or BU 6.
 

Testing authority: State

Test types

  • Follow up - DPA rules

  • Pre-employment - SPB rules

  • Reasonable suspicion - DPA rules

For a drug test (urine collection) only, you need

  • CalHR 177

  • Quest Diagnostics -- Forensic Drug Testing Custody and Control Form

  • 8 Panel - DPA rules

  • 5 Panel - SPB rules

For a breath alcohol test only, you need

  • CalHR 177
  • Quest Diagnostics – Alcohol Testing From (Non-DOT)

For both a drug test (urine collection) and a breath alcohol test, you need

  • CalHR 177
  • Quest Diagnostics -- Forensic Drug Testing Custody and Control Form
  • 8 Panel - DPA rules
  • 5 Panel - SPB rules
  • Quest Diagnostics – Alcohol Testing From (Non-DOT)
 

Testing authority: federal

Test types

  • Follow up
  • Post accident
  • Pre-employment
  • Random
  • Reasonable suspicion
  • Return to duty 

For a Drug Test (Urine Collection) only, You Need

  • CalHR 177
  • Quest Diagnostics -- Federal Drug Testing Custody and Control Form 

For a Breath Alcohol Test only, You Need

  • CalHR 177
  • Quest Diagnostics – U.S. Department of Transportation (DOT) Alcohol Testing Form 

For Both a Drug Test (Urine Collection) and a Breath Alcohol Test, You Need

  • CalHR 177
  • Quest Diagnostics -- Federal Drug Testing Custody and Control Form
  • Quest Diagnostics – U.S. Department of Transportation (DOT) Alcohol Testing Form
 
The CalHR 177 form is available from CalHR.  Contact CalHR’s Drug Testing Unit at http://www.drugtestinginfo@chr.ca.gov
 
The Quest Diagnostics forms are available from your department’s coordinator.  In an emergency, contact Patti McKitterick at (800) 440-3784, ext. 210 (business hours) or ext. 222 (after hours). 

Testing Authority: BU 6 (Department of Corrections and Rehabilitation only)

  • Test Types
  • Random
 
Questions regarding forms used for this program should be directed to the California Department of Corrections and Rehabilitation (CDCR), Office of Employee Wellness at 1 (855) 897-9822.
 

Updated 5/14/2014