FORMS . . .
This form MUST be utilized when sending a donor/employee for a post-accident/incident drug and alcohol test or probable cause drug and alcohol test.
The DER/Supervisor MUST physically accompany the donor/employee and always stay with the donor from the time of the incident to completion of testing. Post-accident and probable cause testing must be performed within 2 hours at an on-site location or within 4 hours at an off-site location. Please inform the collector/collection site that the test MUST be a BCRC Urine Drug Screen and a Breath Alcohol Test.
This form must be completed immediately after a BCRC Post Accident/Probable Cause Drug & Alcohol Test then sent to the BCRC info@bcrcnet.com or faxed to 219.764.9505.
Download Drug & Alcohol Testing Form here
This form is used by participating Contractors to contribute monthly amounts.
REPORTING REQUIREMENTS – Use a separate BCRC Fund Reporting Form for each month reported. Attach a copy of your Man Hour Reports for each trade, with names and social security numbers of each Member remitted. Contributions and reports are Due by the 20th of each month for hours worked the preceding month.
Download BCRC Fund Reporting Form here
Used by Members, Local Unions and/or Contractors to report any member changes or work status.
Download the BCRC Member Application Form here
Used by Members, Local Unions and/or Contractors to report members updated information.
Download the BCRC Member Contact Information Update Form here
Permission form to obtain BCRC Drug Status. Before an employee’s BCRC status can be released to an employer verbally by BCRC, the employee must first sign for the release of his/her status by the use of his/her BCRC ID number or social security number.
Download the BCRC ID Permission Form here
This form MUST be utilized when sending a donor/employee for a post-accident/incident drug and alcohol test or probable cause drug and alcohol test.
The DER/Supervisor MUST physically accompany the donor/employee and always stay with the donor from the time of the incident to completion of testing. Post-accident and probable cause testing must be performed within 2 hours at an on-site location or within 4 hours at an off-site location. Please inform the collector/collection site that the test MUST be a BCRC Urine Drug Screen and a Breath Alcohol Test.
This form must be completed immediately after a BCRC Post Accident/Probable Cause Drug & Alcohol Test then sent to the BCRC info@bcrcnet.com or faxed to 219.764.9505.
Download Drug & Alcohol Testing Form here
This form must be prepared every time an employee displays signs of impairment, possibly due to Drugs and/or Alcohol.
Never accuse an individual of being under the influence of Drugs or Alcohol, only relate Factual Observations. A supervisor who has received Reasonable Suspicion Testing Training is to complete this form.
Note – Retain a copy of this form for a minimum of 5 years and include it in the Employee’s Secure Confidential Drug & Alcohol Program file.
Download the BCRC Reasonable Suspicion Reporting Form here
