Safety Performance/Drug and Alcohol History Records Request

Form Template

In the "Safety Performance/Drug and Alcohol History Records Request" app the employee's authorization for historical drugs and alcohol test will be in a safe and efficient way recorded.

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In compliance with the requirements of 49 CFR, §391.23, a prospective motor carrier employer must perform an an investigation into a driver safety performance history from all previous DOT employers within the last three years. As a previous employer, you are required by 49 CFR, §391.23(g) to respond to this inquiry within 30 days after the request is received.

The employee will authorize release of information from my Department of Transportation regulated Alcohol and Controlled Substances Testing and Safety Performance History records for the previous 3 years for his new job as a driver.

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