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OhioBWC - Employer - Form: (DFSP-4) – Introduction

Drug-Free Safety Program (DFSP) Annual Report - Comparable Program Only (DFSP-4)

Introduction
Employers participating in a comparable drug-free program must submit an annual report to document compliance with all program requirements. The DFSP-4 is that annual report. The report is due the last business day in September for the January program year and the last business day in March for the July program year.

While you're submitting the form online, you must fax all required attachments. For assistance with completing the form, download an example


Required information
You must answer all Yes/No questions. If you answer no, you must explain your answer. Once you submit the online form, you'll receive a confirmation page to print for your records. That page also will have a link to a fax cover sheet, which includes a checklist of required documents that prove compliance and a list of BWC service office fax numbers for you to submit your additional documentation.

  • Policy number, Federal tax ID or Social Security number
  • Contact name and phone number
  • May Drug-Free correspondence be sent to the e-mail address that you provide?
  • Level for next program year
  • Has your company had a state public improvement/construction job during this program year
    • Total number of employees including supervisors who worked/supervised on a state project this program year
    • Number of state construction employees including supervisors who were required to receive one time employee education this program year
    • Number of state construction supervisors who were required to receive one time supervisor training this program year
  • Written DFSP policy
  • Employee education - Name of qualified substance professional(s) used, credentials and dates of service
  • Supervisor training - Name of qualified substance professional(s) used, credentials and dates of service
  • Range of substance testing - number of tests, number of positives by type of test and by specific drug
  • Name of collection site, contact name/phone number, medical review officer, name of SAMHSA-certified lab
  • Verification your company has ensured at least 5-percent random drug testing occurs for your state construction workers and supervisors while they are providing or supervising labor on a State of Ohio construction project
  • Employee assistance resources

If you have all the required information on hand, simply click the start button to begin.

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