Random Drug Testing Acknowledgment Form
Random Drug Testing Acknowledgment Form
Baguio City
Dear Students/Parents/Guardians:
We would like to inform you that the Mandatory Random Drug Testing (RDT) of tertiary
students shall be conducted pursuant to Section 36 of Article III of R.A. 9165 otherwise known
as the “Comprehensive Dangerous Drugs Act of 2002”, in relation to CMO No. 18, series of
2018 of the Commission on Higher Education. Its purposes are to:
The Dangerous Drugs Board issued DDB Regulation No. 3 s. 2009 re: General
Guidelines on Random Drug Testing for guidance and compliance of all concerned. At the back
of this page is an information sheet on how RDT will be done among the randomly selected
students. The RTD can be scheduled at any time.
It is important to mention that the cost of the drug test is borne by government; hence, no
fee shall be charged from the student or parent. Should you have further questions/clarification
on this matter, please get in touch with the Dean of Student Affairs who is the School Drug
Testing Coordinator.
Thank you.
(Cut along this dotted line and submit duly accomplished ACKNOWLEDGEMENT together with the other
requirements)
ACKNOWLEDGEMENT
_______________________________________
Name of Parent/Guardian
(Signature over PRINTED Name)
Date Signed: ___________________
RANDOM DRUG TESTING FLOW CHART
Pre-Specimen Post
Collection Phase Specimen Collection Phase Collection Phase
(eg.masterlist).
including preparation of documents
them on roles and responsibilities
school/institution level and orients
creation of “Selection Board” at the
Supervising Agency requires the
facility
for analysis in an accredited
The analyst prepares the specimen
RDT Team meets with the Selection Board of the School concerned, pays courtesy call and does
orientation, while simultaneously preparing the collection site.
RDT Team and Selection Board, following set procedures, randomly select the students to be tested
from the masterlist provided by the school.
RDT Team orients the student on the process of drug testing and other frequently asked topics
Students who are prepared to give the urine specimen shall approach the analyst table and select a
specimen bottle
confidentially
Supervising Agency to ensure
shall forward a sealed copy to the
*if confirmed positive, the laboratory
with the School Drug Testing Coordinator
Supervising Agency who will coordinate
Results will be forwarded to the
Testing(RDT) in writing
Conduct of Random Drug
parents/families of students on the
Selection Board, informs the
Supervising Agency through the
To safeguard the integrity of the urine sample, the student will be accompanied by a specimen
collector of the same gender to the collection site
The Student will asked to thoroughly wash and dry hands, empty pockets and remove outer garments
(jackets, gowns, etc.) if any . A body search may also be done when necessary.
Student submits urine to specimen collector who then examines, in his/her presence, if urine collected
can be accepted for testing.
Student specimen collector goes back to the analyst table. The student affixes his signature, date and
Team.
RDT and convenes the
plans the conduct of
Health prepares and
the Department of
Supervising Agency and
intervention.
the result and appropriate
parent an the student about
personally inform the
Coordinator shall
The School Drug Testing
The specimen collector “seals” the specimen bottle in the presence of the student.
The specimen collector and student affix final signatures in the drug testing form attesting to the
validity of the procedures done.