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Run: Driver Drug and Alcohol Reasonable Suspicion Observation Form

Document observable signs, incident details, and immediate actions when a driver may be impaired. This form helps supervisors capture a clear, time-stamped r...

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Reporter Information

Reporter name (required)

Reporter role (required)

Reporter contact email or phone

Optional. Provide a contact method only if follow-up is needed.

Driver and Incident Details

Driver name (required)

Employee ID

Optional. Do not collect additional PII unless needed for internal identification.

Date of observation (required)

Time of observation (required)

Location of observation (required)

What was happening when the concern was observed? (required)

Briefly describe the work activity, route, shift, or event without speculation.

Observable Signs

Observed signs (required)

Describe other observable signs

Behavioral notes

Record specific, observable facts such as statements made, actions taken, or performance issues.

Alcohol or Drug Indicators

Which type of concern applies? (required)

Alcohol-related indicators observed

Drug-related indicators observed

Additional details about the indicators

Include only facts you directly observed or heard.

Witnesses and Supporting Information

Were there witnesses? (required)

Witness details

Attach supporting files

Optional. Attach photos, notes, or other relevant documentation if permitted by policy.

Immediate Actions and Follow-up

Immediate action taken (required)

Describe other action taken

Was the driver removed from safety-sensitive duty? (required)

Follow-up notes

Include referral, testing, handoff, or other next steps. Do not include unnecessary PII.

Reporter Certification

Certification (required)

Yes No N/A

Reporter signature (required)

Submission date (required)

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Email (required)

Your name (optional)

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