If a donor provides a specimen and the collector is strongly suspicious that the specimen has been either altered, diluted, or substituted, and the donor refuses to provide another specimen under direct observation the collector must discard the specimen and notify the DER of the refusal either by telephone, e-mail, or secure fax to ensure that notification is immediately received. The collector must document the refusal to test on the CCF and forward all copies of the CCF to the DER.
If a donor fails to follow the observer's instructions to raise and lower his / her clothing and to turn around to permit the observer to determine if the donor has a prosthetic or other device that could be used to interfere with the collection process, this is interfering with the testing process and is considered a refusal to test. The observer, if not the collector, immediately notifies the collector of the donor's failure to follow instructions. The collector stops the collection, notifies the DER as outlined above, documents the refusal on the Federal CCF, and forwards all copies of the CCF to the DER.