CCF

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Federal Drug Testing Custody and Control Form (CCF)

Click each button to learn more. The highlighted sections represent parts that you must ensure are correctly marked, and the information is correctly entered. Make sure you get a copy of the Custody and Control Form (CCF) copy 5 - Donor Copy (not the Test Facility Copy or other) from the collector.

Successful collection

If the specimen is collected successfully, the collector checks 'Split' for DOT drug testing purposes. This is applicable to urine specimen collections.

Designated Employer Representative

Designated Employer Representative (DER) Name, phone and fax. According to 49 CFR part 40, the DER is an employee authorized by the employer to take immediate action(s) to remove employees from safety-sensitive duties, cause employees to be removed from these covered duties, or make required decisions in the testing and evaluation processes.

Your ID info

Your CDL state abbreviation should be followed by your CDL number.

Remarks

Collectors may enter remarks if something unusual occurs during the collection process.

Reason for test

Ensure that correct reason for test is checked

Specimen type

Both urine and oral fluid specimens are authorized for collection and testing under this part. An employer can use one or the other, but not both at the beginning of the testing event. For example, if an employee is sent for a test, either a urine or oral fluid specimen can be collected, but not both simultaneously.

Orla Fluid

If the ORLA FLUID specimen is collected successfully, the collector checks appropriate boxes. This is applicable to oral fluid specimen collections.

DOT Authority

Federal Motor Carrier Safety Administration (FMCSA). FMCSA has to be checked

Drug Test to be performed

The DOT drug test is a 5-drug panel test, which tests for:THC, COC, PCP, OPI, AMP. The box has to be checked.

Collection site info

The collection site is the place where the specimen is collected. This section must include the collection site name, address, and, on the right side of the row, the collection site phone and fax numbers.

Urine temperature

If the specimen is collected successfully, and the temperature is between 90 and 100 F the collector checks the box. This is applicable to urine specimen collections.

Medical Review Officer (MRO) Information

Medical Review Officer (MRO) Name, phone and fax. Medical Review Officers (MRO) are licensed physicians who have been trained and certified to review the lab results and to validate whether a test is positive. MROs receive laboratory confirmed urine drug test results; determine whether there is a legitimate medical explanation for a laboratory confirmed positive, adulterated, or substituted result; and review and report a verified result to the designated employer representative (DER) in a timely and confidential manner. Regulations concerning MROs and the verification process are found in 49 CFR Part 40 Subpart G..