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The page below is a sample from the LabCE course Department of Transportation (DOT) and Department of Health and Human Services (DHHS) Urine Specimen Collection Training. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Completing Step 5 (copy 2) of the Federal Drug Testing CCF: Donor Certification Statement

The collector directs the donor to read and complete the donor's certification statement, located in Step 5 on the MEDICAL REVIEW OFFICER COPY (COPY 2) of the CCF. The donor must provide their printed name, signature, current date, date of birth, plus daytime and evening telephone numbers where the donor may be contacted if necessary. If the donor refuses to complete the necessary information, this is not a refusal to test. The collector should note in the Remarks section under Step 2 on the TEST FACILITY COPY (COPY 1) that the donor refused to provide the requested information.