DOT Alcohol Test Form

DOT Alcohol Test Form (ATF)

Our DOT Alcohol Test Form is a 3-part form that meets the most current Dept. of Transportation revisions effective January 1, 2011. The revision date of 5/2008, located on the bottom left of the form, identifies the new forms. (Yes, even though the form is effective January 2011, the correct revision date really is 5/2008.). This official document records alcohol testing performed under the DOT regulations. It ensures every DOT-regulated alcohol test follows federal procedures and maintains a legal chain of custody.

The DOT designed these alcohol test forms to accommodate instruments that use a slip printer to print results directly on the form, as well as the Alco-Sensor IV @Work software. These DOT alcohol test forms accommodate instruments that use a slip printer to print results directly on the form, as well as the Alco-Sensor IV @Work software.

For a nominal charge we can pre-print your company’s information on the form to eliminate repetitive handwriting of employer information in Step 1 and the BAT Employer information in Step 3. See information about our imprinted DOT alcohol test forms or call for a quotation.

Alcohol Testing Form Features

• 3-part carbonless form meets current DOT requirements
• Record DOT alcohol screening and confirmation test results
• Print friendly with slip printers and Alco-Sensor IV @Work software
• Custom imprinting available for a nominal charge
• Each copy is marked to indicate how copies are distributed (employer, employee, collection site,

What’s On The Form

• Section to record the employee’s information
• Employee signature section step 2
• Reason for the test
• Section to record the DER and company information
• Testing device and 15-min wait period
• Testing type
• Testing site and collector information
• Signature sections
• Remarks section
• Section to record test results