PA DOT Form DL-128 DS. Substance Use Form

Form DL-128 DS is a substance use form used to assess and document an individual's history of substance use for various purposes such as employment, licensing, or legal proceedings. This form aims to gather information about an individual's past and current substance use habits, including drugs and alcohol.

The form typically includes sections where the individual can provide details about their substance use history, including types of substances used, frequency and duration of use, treatment or rehabilitation programs attended, and any legal issues or consequences related to substance use.

Important fields in this form include comprehensive and accurate reporting of substance use history, including any efforts made towards recovery or treatment. The information collected on this form may be used to assess the individual's suitability for certain positions or programs, determine eligibility for licensing or permits, or as evidence in legal proceedings.

Application Example: Various institutions, such as employers, government agencies, or courts, may use this form to evaluate an individual's substance use history. The form should be completed by the individual providing honest and truthful information about their substance use. This form is essential for assessing an individual's ability to meet specific requirements or criteria related to substance use.

Related Forms: Depending on the purpose or context, related forms may include drug testing consent forms, substance abuse evaluation forms, or treatment program enrollment forms.