Drug Testing Custody and Control Form (CCF) Review Checklist
- Does the form read “Federal Drug Testing Custody and Control Form” at the top?
- In Step 1:
- Is the correct employer name and address listed? (The employer’s name must be listed here, not the C/TPA.)
- Is the correct MRO’s name, address phone and fax number listed?
- Is the correct employee ID number or SSN listed?
- Is the DOT box checked? Is the specific DOT Agency box checked?
- Is the reason for the test marked correctly?
- Is the box for THC, COC, PCP, OPI, AMP checked?
- Is the collection site address indicating the location where the test was actually performed and the site’s telephone numbers completed accurately?
- In Step 2:
- Is the Temperature between 90° and 100°F marked “Yes?”
- Is the “Split” collection box marked?
- If it was an observed collection, is the “Observed” box marked? (This box should not be checked if an observed collection was not performed.)
- Is there an appropriate comment included in the Remarks Section? The most common need for remarks include: Temperature Out of Range; Insufficient Volume; Adulteration; and Employee Refuses to Sign.
- In Step 3:
- Even though there is no information provided in Step 3 of the form, look at the bottom of the CCF in the Step 7 portion of the Employer’s copy for a faint shadow, imprint, or traces of carbon ink of a date or the employee’s initials. – During the collection process, the collector dates, and the employee initials, the bottles seals after they have been affixed to the bottles. Carbon shadows in Step 7 indicate the date and/or initials were written on the bottle seals before they were affixed to the bottles. This practice is unacceptable.
- In Step 4:
- Has the collector printed his/her name and signed?
- Is the time and date correct? Make sure the appropriate AM or PM time is indicated. (If an alcohol test was also performed, compare the time on the ATF with the time on the CCF to make sure the alcohol test was completed first.)
- Is the delivery service name clearly identified in the box?
- In Step 5:
- Are the employee’s name, telephone number, and date of birth provided?
- Is the date provided?
- Did the employee sign the form? If not, is this documented in the Remarks Section of Step 2?
