Print Reset STATE OF CALIFORNIA DEPARTMENT OF HUMAN RESOURCES DRUG/ALCOHOL TEST AUTHORIZATION CalHR-177 (REV. 04/09/2012) EMPLOYEES: EMPLOYEES MUST BRING IN AN ALERE/KROLL LABORATORY CUSTODY AND CONTROL.
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How to fill out the Calhr 177 Form online
The Calhr 177 Form is essential for documenting drug and alcohol test authorizations in the state of California. This guide provides a comprehensive overview of how to complete this form online, ensuring accuracy and compliance.
Follow the steps to complete the Calhr 177 Form online
- Click ‘Get Form’ button to access the drug/alcohol test authorization form and open it for editing.
- In Box 1, select the appropriate reason for testing by checking the relevant checkbox. Options include: Follow Up, Post Accident, Post Incident, Pre-Employment, Random, Reasonable Suspicion, and Return to Duty. Specify the test(s) to be performed.
- Fill in Box 2 with the name of the employee to be tested, including their last name, first name, and middle initial. Enter the employee identification number and CBID if applicable.
- Complete Box 3 by providing the name and address of the collection site where the test will occur. Ensure that the details are accurate to avoid any confusion.
- In Box 4, list the telephone number and contact person at the collection site. Include the ordering official’s department, their phone number, and obtain the signature of the ordering official along with the date.
- Review all entered information for accuracy and completeness. Make necessary adjustments as needed.
- Once all sections are correctly filled out, save your changes. You may also choose to download, print, or share the completed form as needed.
Complete the Calhr 177 Form online today to ensure timely processing of drug and alcohol test authorizations.
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