DOT/Non DOT Certification Registration

DOT/NON DOT Certification

Registration Form
Please select what course you are looking to enroll.
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MI
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Course Questionnaire

Rows	Yes	No
Do you have a collector certificate?
Do you have Split specimen kits?
Is your collector certificate expired?

***Please attach a copy of your collector certificate if applicable**

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DOT Specimen Collectors must receive “qualification training” in order to comply with the Federal Regulations included in 49 CFR Part 40. Certified Training Solutions’ online qualification training course includes the DOT-required information such as:

1.       How to complete all steps necessary to conduct a urine specimen collection correctly and the proper completion and transmission of the Custody & Control Form (CCF);

2.       How to handle “problem collections” (e.g., situations like “shy bladder” and attempts to tamper with a specimen).

3.       When is a Direct Observation collection necessary & how the directly observed collection must be conducted; along with training on monitored collection situations.

4.       What are fatal flaws and correctable flaws; and how to correct problems in collections.

**Train the Trainer course please be prepared to teach & provide your own power point.

1.       DOT Collector Requirements and Teaching Materials for Train the Trainer course

-          Materials – Split Specimen kits, Regulated Chain of Custody forms.

-          Materials – can be provide at an additional cost.

2.       Maintain the integrity of the collection process

3.       Ensure the privacy of employees being tested

4.       Ensure the security of the specimen

5.       Topics

*Please Make Sure To Attend Your Scheduled Couse As There Will Be No Refunds*

By signing below, I am acknowledging that I have read, understand, and agree to comply with the course requirements.
Course Cost

Train The Trainer with Your own Materials $175.00
Train the Trainer Material Provided by MKE HEalth Solutions $200.00
Collectors Course $200.00

Collectors course will automatically come with materials.

Train the Trainer materials are an additional cost if provided by MKE Health Solutions LLC.

****Materials: Split Specimen Kit/Chain of custody form.

Once registered a representative of MKE Health Solutions will contact to arrange time and date of course and at that time you will receive an invoice from Quickbooks to pay for course in advance.

Payment Accepted Visa, Mastercard, Apple Pay, Discover, American Express.

Once payment received your materials needed will be sent to you prior to class. Your certificate will be sent via email after successfully passing. MKEHS will work with every student to assure they are successful.

****This course is a interactive course via zoom***

Please contact Yutasha Wilks with any questions or concerns (414) 885-3070 ext: 801
Please upload a photo of your driver License/ID to verify your identity
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DOT/NON DOT Certification