Get Wa Dr-500-013 2011-2026

The WA DR-500-013 form is essential for reporting positive or refused drug and alcohol tests for individuals in transportation roles. This guide will provide clear instructions on how to accurately fill out the form online, ensuring compliance and proper reporting of testing results.

Follow the steps to successfully complete the WA DR-500-013 form.

1. Click the ‘Get Form’ button to access the WA DR-500-013 form online.
2. Begin filling out the driver's personal information. Enter the driver's name (last, first, middle initial), date of birth, driver license number, and social security number.
3. Provide the employer, motor carrier, or consortium name alongside their mailing address, including the address, city, state, and ZIP code.
4. Fill in the email address for additional communication. Then select the reason for the drug or alcohol test from the options provided: pre-employment, random, reasonable suspicion, post accident, return to duty, or follow-up.
5. Indicate whether the driver tested positive or refused the test. Specify the date of the test and list the specific drug(s) involved or note if the refusal was related to adulteration or substitution of the sample.
6. Complete the section for the Medical Review Officer, including the specimen ID number, date of the test, and any drugs found, along with the laboratory name. Additionally, note any adulterants found and whether a split sample was tested.
7. The Breath Alcohol Technician section requires the test number, date and time of the test, instrument name, and serial number.
8. The Medical Review Officer or Breath Alcohol Technician should provide their name, title, telephone number, address, and email.
9. Answer the two compliance questions regarding federal requirements and protocol adherence by selecting ‘Yes’ or ‘No’ as applicable.
10. Type or print the name of the individual certifying the information, followed by the date, place, and title, ensuring to sign the document. Note that stamped signatures are not accepted.
11. Upon completion of the form, save your changes, and you can choose to download, print, or share the form as needed.

Complete your forms online today for efficient processing and to ensure accuracy.