Get Utah State Toxicology Request Form

Filling out the Utah State Toxicology Request Form is a crucial step in initiating toxicology analysis. This guide will provide you with step-by-step instructions to ensure that you complete the form accurately and efficiently.

Follow the steps to fill out the form correctly.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the subject information. Fill in the last name, first name, and middle name of the subject. Select the subject's gender from the options provided.
3. Provide the agency information, including the agency/section name, requesting officer's name, date of birth of the subject, I.D. number, agency case number, and the type of I.D. (e.g., Driver License).
4. In the offense information section, specify the subject type (e.g., driver) and the offense date.
5. Proceed to the sample information section. Enter the incident time in 24-hour format, the collection date, the sample type, and the number of samples collected for blood and urine.
6. Indicate the nature of the incident by checking all that apply (e.g., DUI, felony, accident, fatality, drug-facilitated sexual assault). Provide a list of any drugs suspected, found, or of interest.
7. Ensure that you check the sample submission checklist. Confirm that each container is properly labeled and sealed, and that the completed form accompanies the samples.
8. Lastly, review the form for accuracy. You may save the completed form by downloading or printing it as a PDF before submission.

Start filling out your Utah State Toxicology Request Form online today.