INDEPENDENT CONTRACTOR TESTING HISTORY FORM
Carrier is regulated by the Department of Transportation (DOT) must ask all prospective Drivers offered DOT-regulated positions whether they have tested positive or refused to test on any DOT-required pre- contractual drug or alcohol test in the preceding two years. Please respond “yes” or “no” to the following questions by placing an “X” in the appropriate space.
3. If you responded “Yes” to either Question 1 or 2 above, have you successfully completed the DOT- required return-to-duty process?
- or -
Please provide the name, address, and telephone number of the Substance Abuse Professional (SAP), if any, to which you were referred as part of the DOT-required return-to-duty process: