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Appendix: Drug-Testing Forms

The forms on the following pages are recommended for drug-testing programs. These may be duplicated and/or adapted for individual agency use. The source of each form is indicated at the bottom of each page. Those from the American Probation and Parole Association (forms 1-14) are from Drug Testing Guidelines and Practices for Juvenile Probation and Parole Agencies, published by the Office of Juvenile Justice and Delinquency Prevention in 1992. Those from the American Correctional Association and Institute for Behavior and Health, Inc. (forms 15-18) are from Prototype Drug Testing Program for Juvenile Detainees, published by the American Correctional Association in 1991.

LineAmerican Probation and Parole Association forms
LineForm 1: Instructions to Juvenile Offenders
LineForm 2: Drug-Testing Agreement
LineForm 3: Request for Drug Test(s)
LineForm 4: Substance/Medication Screen Record
LineForm 5: Specimen Collection Checklist
LineForm 6: Specimen Container Seal and Label
LineForm 7: Chain of Custody Form
LineForm 8: Urinalysis Report
LineForm 9: Positive Drug Test Statement
LineForm 10: Authorization for Release of Drug Test and Result Information
LineForm 11: Urinalysis Test Record
LineForm 12: Probationer/Parolee Status Report
LineForm 13: Agency Monthly Drug-Testing Summary Log
LineForm 14: Drug-Testing Control Log

LineAmerican Correctional Association/Institute for Behavior and Health, Inc.
LineForm 15: Urine Test Consent Form
LineForm 16: Chain of Custody Form for Onsite Drug Testing
LineForm 17: Drug Test Request Form for Onsite Testing Program
LineForm 18: Record of Drug Test Results


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Drug Identification and Testing in the Juvenile Justice System May 1998