Positive/Refused Drug/Alcohol Test Report

Use these forms to report positive drug or alcohol tests, or refusals to take the tests. The reports must be submitted to us within 3 business days of the confirmed test.

Instructions

Fill out the form completely, and print it on white paper.

If you are: Use this form:
A medical review officer or breath alcohol technician Positive/Refused Drug/Alcohol Test Report
An employer or motor carrier Positive/Refused Drug/Alcohol Test Report by Employer

How to submit the form

  • Mail the completed form to:
    Mandatory Suspension
    Department of Licensing
    PO Box 9030
    Olympia, WA 98507-9030
  • or
  • Fax it to 360.570.7826.
Washington Healthcare Finder
Access Washington – official state government website