Coast Guard Drug testing program

Add or Delete Captains or Crew from your Maritime Membership

If your company is not currently enrolled, please go to new membership application

Directions: Please read and complete each part of this form.

Applications with credit cards can be submitted online via secure server. Check payments must be sent regular mail.

If you are adding ANY crew members, you must comply with the DOT regulation concerning a background check.

"*" indicates required fields

Crew Members

You must enter a Social Security Number with dashes and a name, otherwise this can not be processed

If you mark a crewmembers as exempt, you must provide us with a negative DOT test dated within the last 6 months or a letter of compliance, on Company letterhead, dated within the last 30 days. Please email to info@drugfreevessel.com

Note: Maritime ID Cards will be issued upon receipt of documentation of pre-employment status.

Enter the total number of crew you want to add in the box – “Number of crew members to Add”

This field is hidden when viewing the form

Enter the number of crew who need a test in the box “Crew Members Who Need a Test” and enter the number of crew who do not need a test in the box “Crew Members Who are Exempt”. Drop Down boxes will appear below the line and you will enter the information on those lines. Please make sure you fill in the Name, SSN and Date of Birth.

Note: For every person you delete from your program, you can add one above for no enrollment fee

Note: Maritime ID Cards will be issued upon receipt of documentation of pre-employment status.

Membership Fee

(from above) $75 per person. $85 in AK, HI, PR, VI. For Saipan and Guam $100 per person. Does not include any discounts.
(from above)
$60 per test
$20 per kit (covers one captain/crewmember) (Mailed out within 2-3 weeks unless FEDEX is requested) See here for regulation
Shipping Method*
(Please specify Priority or Overnight shipping)

Payment Information

Payment Method*