Placer — Drug Testing Order

Source: https://www.placer.courts.ca.gov/sites/default/files/pl-fl900-drug-testing-order.pdf

SUPERIOR COURT OF THE STATE OF CALIFORNIA, COUNTY OF PLACER

Superior Court of California, County of Placer 10820 Justice Center Drive 2501 N. Lake Blvd. P. O. Box 619072 P.O. Box 5669 Roseville, CA 95661-9072 Tahoe City, CA 96145

PETITIONER: RESPONDENT:

COURT ORDER FOR SUBSTANCE AND/OR ALCOHOL TESTING CASE NUMBER:

1. Petitioner/Respondent, ___________________________________ shall submit to the following test:
Urine: Oral Fluid:
72 hour 5 drug panel test 72 hour 5 panel test
72 hour 10 panel test 72 hour 9 drug panel test
72 hour EtG (Alcohol) test 72 hour EtG (Alcohol) test
Other Test: __________________________ 8 hour THC test

Hair/Fingernail by Stipulation/Agreement: Oral Fluid Alcohol Screening by Stipulation/Agreement:
90 day drug test Q.E.D saliva alcohol test
90 day EtG (Alcohol) test Other Test: __________________________

2. The testing frequency and reporting shall be as follows:
One test. The testing parent/party shall submit to one test and is hereby ordered to report to a licensed testing facility of
their choice (see below.)
Immediately, or within ______ hours or _____ days, for testing.
By random call from the testing facility, up to ______ tests per month, for a duration of:
______ number of months.
Until ______ number of consecutive tests have been clean, as determined by the testing facility.
Until further order of the Court.
By request of the other parent, up to ______ tests per month, for a duration of:
______ number of months.
Until ______ number of consecutive tests have been clean, as determined by the testing facility.
Until further order of the Court.

3. The licensed “testing facility” shall be chosen by the parent/party ordered to submit to testing.
4. Testing Facility: Testing shall only be conducted by a qualified provider, pursuant to FC§3041.5 A list of qualified
providers (testing facilities) can be found on the Placer County Superior Court website.
5. The testing parent/party and their attorney (if represented) shall provide their contact information and the contact information
of the other parent/party and attorney (if represented) (including: name, phone number and email address) and a copy of this
Order to the testing facility upon reporting to the testing facility for the first time of testing pursuant to this order.
6. The testing parent/party shall immediately notify the other parent/party to this matter by email or text message of the facility
chosen by the testing parent/party.
7. If the test request is by random call from the facility or by request of the other parent/party, the testing parent/party shall
report for testing within ______ hours or 24 hours if no hours are specified.
8. The testing parent/party shall sign a release of information with the testing facility that will allow the non-testing parent/party
to obtain a copy of the test results from the qualified facility. If the release of information is not signed it shall be considered
a violation of this order.
9. The cost for testing shall be paid as follows:
Solely by the testing parent/party.
Solely by the non-testing parent/party.
½ by the testing parent/party and ½ by the non-testing parent/party.
By the testing parent/party for positive tests, and by the non-testing parent/party for clean tests.
For all tests, the testing parent/party shall advance the cost for each test and shall be reimbursed based on the
above orders upon request to the non-testing parent/party within 30 days. The request for reimbursement shall
include a receipt for the test and a copy of the test results.
In the event a test is positive, the testing parent/party shall also bear the cost of obtaining a report from the
testing facility that evidences the positive result.
Orders for costs/fees for testing are subject to reallocation by the court.

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Superior Court of California, County of Placer www.placer.courts.ca.gov Form No. PL-FL900 Page 1 of 2 Effective 9-22-2022

SUPERIOR COURT OF THE STATE OF CALIFORNIA, COUNTY OF PLACER

STIPULATION

In the best interest of the children, the parties agree that if the test results are positive, the non-testing parent/party shall

not turn over the child(ren) for unsupervised parenting time and shall file for a change of the court orders within five business days. If the non-testing parent/party does not file for court orders within this time, the testing parent/party may seek appropriate court orders within ten (10) days. If neither seeks to modify the custody orders then the orders in effect prior to the positive test shall remain, be effective and all parties shall comply with the custody and visitation orders.

10. Other Orders:

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If the testing parent/party fails to test as directed above, the test will be considered presumptively positive.

If the chain of custody, as recorded by the testing facility, indicates that the testing parent/party attempted to adulterate or dilute a specimen, or otherwise attempted to manipulate the testing process and/or the test results, the test will be considered to be presumptively considered positive.

NOTE: It is the responsibility of the parent/party seeking to have any test results considered by the Court to bring such test results to the next court hearing.

We have read the entire stipulation and agreement. We understand it fully and request the Court to make our stipulation and agreement an order of the court. We understand that willful failure to comply with the provisions of this order will be a contempt of court and may be punished as allowed by civil contempt proceedings. We waive all further notice of this order.

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Petitioner Respondent

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Attorney for Petitioner Attorney for Respondent

Both parties were voir dired in open court and orally agreed and stipulated to this testing order.

IT IS SO ORDERED:

Dated: ____________________ ________________________________________ JUDGE/COMMISSIONER OF THE SUPERIOR COURT

Pursuant to Family Code Section 3041.5, the results of all testing herein are confidential and may not be released to anyone other than the court, the parties, or the attorneys. The person offering the test results to the court is responsible for requesting the court clerks to lodge the result in the court’s confidential file.

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Superior Court of California, County of Placer www.placer.courts.ca.gov Form No. PL-FL900 Page 2 of 2 Effective 9-22-2022