Drug & Alcohol · Free Form
DOT Drug & Alcohol Policy Receipt
Document a driver’s receipt of the employer’s DOT testing policy and educational materials with clear version and contact details.
Who It’s For
Employers documenting distribution of Part 382 policy and educational materials.
How to Use It
Distribute the actual policy and required educational materials, then have the driver sign the receipt. Complete the employer’s content check against the materials themselves. This one-page receipt is not a complete drug-and-alcohol policy or testing consent.
What’s Included
- Policy version and distribution details
- Required-content review prompts
- Signed receipt and record location
The employer must retain the signed receipt under 382.601(d). Review all details in 382.601(b), including Clearinghouse reporting information. Keep testing results and other confidential program records in their proper restricted location.
Put It into Practice
Need help applying this to your operation? Run the DOT Compliance Self-Check.
Related Downloads
Official References
Check the applicable requirements alongside your company procedures.
Using This Download
Is this a fillable PDF?
This is a printable 1-page PDF. Complete it by hand after printing, or add text with a PDF editor. It does not contain interactive form fields.
Can MSM customize it for our company?
Yes. MSM clients can ask their MSM team to adapt the resource to company procedures, reporting contacts, equipment, and branding. The standard public download is available to everyone.
Reviewed October 26, 2026. These resources support U.S. trucking safety work. Apply the rules, exceptions, equipment instructions, and state requirements relevant to your operation. A completed form does not by itself establish compliance.