Yes, a sample limited consent form is available. FMCSA does not require that motor carrier employers subject to the Agency’s drug and alcohol use and testing regulations in 49 CFR Part 382 use this sample format to obtain an employee’s consent to conduct a limited query of the Drug and Alcohol Clearinghouse. Employers may, however, use or adapt the content as they see fit.

Section 382.703(a) states “No employer may query the Clearinghouse to determine whether a record exists for any particular driver without first obtaining that driver’s written or electronic consent.” The type of consent required depends on the type of query.

For a limited query, a general consent is required. This is obtained outside the Clearinghouse. Employers may obtain a multi-year general consent from the driver for limited queries. A sample limited consent form from the Federal Motor Carrier Safety Administration (FMCSA) is available.

For a full query, the driver must provide specific consent to the employer prior to each full query. This consent must be provided electronically within the Clearinghouse.

Yes. In accordance with the Drug and Alcohol Clearinghouse Terms of Use, the following actions may result in revocation of your Clearinghouse registration under 49 CFR § 382.713.

1. Failure to comply with the FMCSA IT Rules of Behavior.
2. Failure to comply with the Clearinghouse Terms of Use.
3. Failure to comply with the Clearinghouse requirements in 49 CFR Part 382.
4. Failure to comply with an FMCSA request for copies of documents related to the Clearinghouse (e.g., copies of consent forms).
5. Failure to comply with any of the prescribed rights and restrictions on access to the Clearinghouse, including but not limited to, submission of inaccurate or false information and misuse or misappropriation of access rights or protected information from the Clearinghouse and failure to maintain the requisite qualifications, certifications and/or training requirements as set forth in 49 CFR Part 40.
6. For Service Agents, failure to perform the duties prescribed under 49 CFR Parts 40 and 382, or being subject to a Public Interest Exclusion under 49 CFR Part 40, Subpart R.
7. Being under government-wide suspension or debarment under 2 CFR part 180.

The procedures governing Clearinghouse registration revocation are set forth in the Clearinghouse Terms of Use; see the Clearinghouse Terms of Use or the Clearinghouse Terms of Use for Employers.