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DOT & Regulatory Compliance PG&E Supervisory Referral Form (For Discovered SelfIdentified Employees) NOTE: Use this form if the employee you are referring is in a DOT covered position and has acknowledged

How to fill out dot supervisory referral form

How to fill out DOT supervisory referral form:

1. Start by providing the necessary information at the top of the form. This includes the employee's name, employee ID, and contact details.
2. Next, indicate the reason for the referral. This could be due to a violation of DOT regulations, a positive drug or alcohol test, or other performance-related issues.
3. Specify the date and time of the incident or violation that led to the referral.
4. Describe the details of the incident or violation in the space provided. Be concise and focus on the facts.
5. Document any witnesses or individuals involved in the incident. Include their names, job titles, and contact information if available.
6. Identify any supporting documentation that should be included with the referral form, such as video footage, test results, or incident reports.
7. Provide your own contact information as the supervisor making the referral. Include your name, job title, and contact details.
8. Finally, sign and date the form to certify its accuracy and completeness.

Who needs DOT supervisory referral form?

1. Employers in the transportation industry who are regulated by the Department of Transportation (DOT) are required to use the DOT supervisory referral form.
2. Supervisors within these organizations who need to report any violations, incidents, or performance issues involving their employees should utilize the form.
3. Further, any employee who has been involved in a violation or incident that falls under DOT regulations may be subject to a supervisory referral and the accompanying form.

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What is dot supervisory referral form?

The DOT supervisory referral form is a document used to report an employee to the Department of Transportation for drug or alcohol testing.

Who is required to file dot supervisory referral form?

Supervisors or employers who have reasonable suspicion that an employee is using drugs or alcohol on the job are required to file the DOT supervisory referral form.

How to fill out dot supervisory referral form?

The DOT supervisory referral form must be completed with details about the employee, the reason for referral, dates and times of observations, and any other relevant information.

What is the purpose of dot supervisory referral form?

The purpose of the DOT supervisory referral form is to ensure the safety of employees and the public by addressing and testing employees who may be under the influence of drugs or alcohol while on the job.

What information must be reported on dot supervisory referral form?

The DOT supervisory referral form must include the name of the employee, the reason for referral, dates and times of observations, and any other relevant details.