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Health Concerns

Request for Controlled Substances for Training Purposes and Kit History

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HC protected "A" once completed

  • Kit Number :
  • New, Replacement, Addition
    1. Complete sections 1, 2, 3, 4 and 8
    2. Retain a copy for your files and mail original to address below
    3. Upon receipt of kit, complete section 6 and fax to DDTK unit
  • Health Canada, DDTK Unit
    Drug Analysis Service
    2301 Midland Avenue
    Scarborough, ON M1P 4R7
    Tel: 416-954-2147
    Fax: 416-954-5923
    Email: ddtk-tedd@hc-sc.gc.ca
  • Return of Used Kit
    1. Complete section 6 and include copy in return shipment
    2. Courier used kit and copy of completed form to address shown below left
  • DAS use only
    • Date received:
    • Verified by:
    • Courier:
    • Verified date:
    • Waybill:
    • Destruction bag:
  • (1) Kit requested by
    • Full Name:
    • Rank/Title:
    • Address:
    • Telephone:
    • Fax:
    • E-Mail:
    • Signature:
    • Date:
  • (2) Deliver kit to
    • Institution:
    • Address (if different from section 1). Avoid POBs/RRs, if possible.
  • (3) Dog & Handler information
    • Handler:
    • Telephone:
    • Rank:
    • Dog:
  • (4) Requirements
    • Controlled Substance
      • Hashish
      • Hash oil
      • Marijuana
      • Heroin (low grade)
      • Heroin (high grade)
      • Cocaine (low grade)
      • Cocaine (high grade)
      • Crack cocaine
      • Methamphetamine
      • MDMA (Ecstasy)
    • Standard issue
      • 25 g
      • 2 vials
      • 75 g
      • 20 g
      • 20 g
      • 20 g
      • 20 g
      • 10 g
      • 10 g
      • 10 g
  • (5) Issued by DAS
    • Quantity
    • Issued
    • Strength/descriptor
    • Bag/container weight
    • Inventory control #
  • (6) Received
    • Discrepancy (issued vs received)
    • Verified/handler's initials
  • (7) Returned
    • Quantity returned to HC
    • Difference (issued vs returned)
    • Handler's initials
  • DAS
    • Quantity received by HC
  • Comments:
  • (8) Authorized by (E.G., Senior Official, Chief of Police or Commanding Officer)
    • I certify that the requested substances are for detector training purposes only and that the information provided on this application is correct
    • Full Name:
    • Rank/Title:
    • Signature:
    • Date:
    • Address: Same as Section (1) or Same as Section (2)
      or Complete if different from 1 or 2
  • DAS use only
    • Request received by:
    • Kit prepared by:
    • Date:
    • Date:
    • Waybill:
    • Outstanding kit(s):
    • Comments:
  • HC9207E (Revision: Jun. 2010)