Text consolidated by Valsts valodas centrs (State Language Centre) with amending regulations of: 22 December 2009 [shall come into force on 30 December 2009]; 20 September 2011 [shall come into force on 30 September 2011]; 22 May 2012 [shall come into force on 25 May 2012]; 25 June 2013 [shall come into force on 28 June 2013]; 3 September 2013 [shall come into force on 1 January 2014]. If a whole or part of a paragraph has been amended, the date of the amending regulation appears in square brackets at the end of the paragraph. If a whole paragraph or sub-paragraph has been deleted, the date of the deletion appears in square brackets beside the deleted paragraph or sub-paragraph.

Republic of Latvia Cabinet Regulation No. 394 Adopted 2 June 2008

Procedures for Detecting the Influence of Alcohol, Narcotic, Psychotropic or Toxic Substances

Issued pursuant to
Section 60.¹ of the Medical Treatment Law
[25 June 2013]

I. General Provisions

1. This Regulation prescribes the procedures, by which the influence of alcohol, narcotic, psychotropic or toxic substances shall be detected.

[25 June 2013]

2. This Regulation (except Annexes 8, 9, 10, and 11) shall not apply to the procedures, by which alcohol concentration in the blood and exhaled air of a driver, as well as the influence of narcotic or other substances, shall be determined.

3. The possible influence of alcohol, narcotic, psychotropic or toxic substances shall be tested:

3.1. by the State Police, municipal police, Port Police, State Border Guard employee, inspector of the State agency "Civil Aviation Agency", or official of the State Probation Service, by using a portable measuring device for the determination of alcohol concentration in the exhaled air, in order to establish, whether the person has used any alcohol;

3.2. by performing a medical check-up at a medical treatment institution (Annex 1) or at a specialised mobile medical laboratory of the said medical treatment institution, on the basis of the referral referred to in Paragraph 6 of this Regulation, or a submission of the person referred to in Paragraph 7 of this Regulation;

3.3. at any medical treatment institution (in addition to the institutions referred to in Annex 1 to this Regulation), in accordance with Chapter IV of this Regulation, when providing medical aid to a person who has been injured.

[25 June 2013]

4. The portable measuring device for the determination of alcohol concentration in the exhaled air (hereinafter - the meter) used in the detection shall comply with the requirements stipulated by the Cabinet for meters used for the determination of alcohol concentration in the exhaled air.

5. Medical check-up shall be performed by a certified narcologist or a physician of another speciality who has acquired the relevant method of medical check-up for the determination of blood alcohol concentration and for the detection of the influence of narcotic or intoxicating substances in any of the medical treatment institutions referred to in Annex 1 to this Regulation, in which it is possible to perform investigations, by using enzymatic immune method, gas chromatography method and the method of chemical-toxicological investigation, and where the chemical-toxicological expert-examination is performed by certified forensic experts (hereinafter - specialised medical treatment institution), and who has acquired the relevant certificate of medicinal and diagnostic methods in accordance with the procedures laid down in laws and regulations (hereinafter - physician).

[22 December 2009]

6. Medical check-up shall be performed on the basis of a written referral of the official of a law enforcement authority (Prosecutor's Office, court, State Police, municipal police, Port Police), head of the State or local government authority, as well as of a commercial company or another institution, or a person authorised by him or her, stating the reason for the medical check-up (Annex 2).

[25 June 2013]

7. Medical check-up shall be performed upon request of a natural person, provided that this person files a submission (Annex 3) with a medical treatment institution stating the reasons for the check-up and presents a personal identification document. The submission shall be attached to the medical check-up report.

II. Test of Alcohol Concentration in the Exhaled Air

[25 June 2013]

8. Alcohol concentration in the exhaled air of a person shall be tested:

8.1. by the State Police, municipal police, Port Police, or State Border Guard employee, in order to confirm or refute the fact of a violation of law, or to review objectively a matter regarding the commitment of a violation of law;

8.2. by an official of the State Probation Service:

8.2.1. during the period of serving the criminal punishment - community service - at the State Probation Service or at the place of implementation of the community service;

8.2.2. during the term of probation or unserved term of the sentence, or during the term of probation supervision specified by the court, at the State Probation Service, as well as at any place, provided that the probation client has been imposed a restriction regarding alcohol consumption;

8.2.3. at the place of implementation of a probation programme;

8.3. by an inspector of the State agency "Civil Aviation Agency", in order to establish, whether the civil aviation personnel has used any alcohol while on duty in the field of civil aviation.

[22 May 2012; 25 June 2013]

9. The testing of a person shall be performed upon his or her oral consent.

10. If it is not possible to perform the testing for determination of the alcohol concentration in the exhaled air, or if the person does not agree to the performance of the test or the results thereof, an employee of the State Police, municipal police, Port Police, or State Border Guard, or, in cases specified in Sub-paragraph 8.2 of this Regulation, an official of the State Probation Service, with the consent of the probation client, or, in cases specified in Sub-paragraph 8.3 of this Regulation, an inspector of the State agency "Civil Aviation Agency", with the consent of the civil aviation personnel, shall deliver the relevant person to the medical treatment institution as soon as possible for the performance of a medical check-up.

[25 June 2013]

11. The testing of a person shall be performed by taking two measurements with an interval of 15-20 minutes. Taking into account the conditions provided for in the laws and regulations regarding requirements for meters, the alcohol concentration displayed by the meter in the exhaled air shall be comparable to the blood alcohol concentration.

12. If the measurements show alcohol concentration in the exhaled air, an employee of the State Police, municipal police, Port Police, or State Border Guard, or an inspector of the State agency "Civil Aviation Agency", or an official of the State Probation Service shall draw up a report on check-up of the person (Annex 4). Print-outs of the meter attesting to the measurements indicated in the report shall be attached to the report.

[25 June 2013]

13. The person shall confirm with a signature that he or she has become acquainted with the report and agrees with the results of the test.

14. If the alcohol concentration in the exhaled air is equal to or exceeds 0.5 per mille, the person shall cover the expenses of the check-up in the amount of 15.65 euros.

[3 September 2013]

15. Paragraph 14 of this Regulation shall not apply to tests for determination of alcohol concentration in the exhaled air performed by an official of the State Probation Service or an inspector of the State agency "Civil Aviation Agency".

[25 June 2013]

III. Procedures for Medical Check-up

16. A medical check-up shall include:

16.1. check-up of the fact of use of alcoholic, narcotic, psychotropic, toxic substances or medicinal products according to the words of the person to be checked up;

16.2. check-up of the outer appearance (including the presence or absence of bodily injuries), mental and emotional condition, behaviour, speech, vegetative-somatic condition and movement coordination, and determination of alcohol or other odours;

16.3. determination of the fact of use of alcoholic, narcotic, psychotropic, toxic substances or medicinal products, by determining the alcohol concentration in the exhaled air, as well as by performing investigation of blood, urine, or saliva (hereinafter - biological environment) in a laboratory. Results of the check-up and opinion shall be entered in the medical check-up report.

17. Prior to performing a medical check-up, the physician shall verify the identity of the person to be checked up by examining his or her personal identification document. If no personal identification document is presented, the outer appearance of the person to be checked up shall be described in the medical check-up report and it shall be indicated that the personal data has been established orally according to the words of the person to be checked up or according to the data provided by the person who delivered the person to be checked up to the medical treatment institution.

18. In determining the alcohol concentration in the exhaled air, two measurements shall be performed with the interval of 15-20 minutes. Taking into account the conditions provided for in the laws and regulations regarding requirements for meters, the alcohol concentration displayed by the meter in the exhaled air shall be comparable to the blood alcohol concentration.

19. In order to determine the blood alcohol concentration in a biological environment by laboratory means, the enzymatic immune method or gas chromatography method shall be used.

20. In order to determine the influence of narcotic, psychotropic or toxic substances, certified forensic experts shall perform chemical-toxicological expert-examination, using the chemical-toxicological investigation methods.

[22 December 2009]

21. If a medical check-up for the determination of the influence of alcohol, narcotic, psychotropic or toxic substances cannot be performed to a full extent, or if it is difficult to perform the check-up due to the overall condition of the person to be checked up, the detectable clinical symptoms shall be assessed and laboratory investigations shall be performed in two different biological environments.

22. In accordance with Annex 5 to this Regulation, biological environment samples (except urine) for laboratory investigations shall be taken in a medical treatment institution by a medical practitioner and in the presence of the referring person. Urine samples shall be taken under the supervision of a medical practitioner.

23. In order to determine the alcohol concentration in the biological environment, samples of materials for laboratory investigation shall be transferred together with a referral for determination of alcohol in the biological environment (Annex 6). The referral shall indicate the given name and surname of the medical practitioner who took the sample (the medical practitioner shall sign the referral and confirm the record with a stamp).

24. Samples of materials shall be provided for the chemical-toxicological investigation together with a referral for chemical-toxicological investigation (Annex 7). The referral shall indicate the given name and surname of the medical practitioner who took the sample (the medical practitioner shall sign the referral and confirm the record with a stamp).

25. If the results of the clinical investigation do not match the results of the laboratory investigations (the substance has not been detected), the medical treatment institution shall send the biological environment samples to a specialised medical treatment institution for a repeat examination (laboratory investigations). After the results of the repeat laboratory investigations have been received, the final opinion shall be provided by the physician who performed the medical check-up.

26. If the results of the clinical investigation do not match the results of the laboratory investigations (the substance has not been detected) and the first laboratory investigation of the biological environment was performed in a specialised medical treatment institution, the final opinion after the repeat laboratory examination of the biological environment samples shall be provided by another physician of the specialised medical treatment institution.

27. The medical check-up report shall be drawn up by a physician in two copies (Annex 8 or 9). If chemical-toxicological examination is performed in addition, results of the chemical-toxicological examination shall be attached to the medical check-up report (Annex 10). The medical check-up report shall be assigned a number, and an entry in the register (Annex 11) shall be made stating the fact of medical check-up and other necessary information on the person for whom influence of alcohol, narcotic, psychotropic or toxic substances has been detected.

28. Influence of alcohol in the medical check-up report is indicated, if the blood alcohol concentration in the person to be checked up:

28.1. is equal to or exceeds 0.5 per mille or similar concentration in another biological environment;

28.2. is equal to or exceeds 0.2 per mille or similar concentration in another biological environment, if the person to be checked up represents civil aviation personnel.

[25 June 2013]

29. The results obtained in performing the actions referred to in this Regulation shall be described in detail and one of the following conditions of the person checked shall be approved in the medical check-up report:

29.1. no influence of alcohol has been detected;

29.2. no influence of narcotic, psychotropic or toxic substances has been detected;

29.3. no influence of alcohol, narcotic, psychotropic or toxic substances has been detected, but functional disorders have been observed, due to which it is necessary to avoid high-risk conditions;

29.4. the influence of alcohol has been detected;

29.5. the influence of narcotic, psychotropic or toxic substances has been detected;

29.6. both the influence of alcohol and the influence of narcotic, psychotropic or toxic substances (concurrently) has been detected;

29.7. the fact of use of a particular substance has been detected, but the influence of narcotic, psychotropic or toxic substances has not been detected;

29.8. alcohol intoxication has been detected;

29.9. intoxication with narcotic, psychotropic or toxic substances has been detected;

29.10. drug-induced intoxication has been detected;

29.11. intoxication (influence) of narcotic, psychotropic or toxic substances has been detected clinically.

[22 December 2009]

30. The medical check-up report shall be drawn up and the opinion on the condition of the person to be checked up shall be provided during the medical check-up.

31. The medical treatment institution shall transfer one copy of the medical check-up report to the person requesting (referring for) medical check-up. The other copy of the medical check-up report, referral to a medical check-up or submission of the person, results of laboratory investigations, as well as the register shall be stored by the medical treatment institution for five years.

32. The results of a medical check-up shall be notified orally to the person to be checked up. A written statement of the results of the medical check-up shall be issued upon oral request of the person to be checked up.

33. The person to be checked up shall confirm that his or her medical check-up has been performed by signing the medical check-up report.

34. If the person to be checked up refuses to undergo a medical check-up, refuses to provide biological environment samples for laboratory investigations, or refuses to sign, or is not capable of signing, the medical check-up report, or tries to take action, which may change the results of the medical check-up, the physician shall state this in the medical check-up report. The fact of refusal to undergo a medical check-up shall be mentioned in the section "Opinion" of the medical check-up report (the opinion shall be provided, taking into account the results of clinical investigation, and it shall be indicated that the opinion is based on clinical symptomatics).

[22 December 2009]

35. If the person to be checked up does not agree with the results of the medical check-up, he or she shall have the right to request, within a month, a repeat laboratory investigation of biological environment at the specialised medical treatment institution where the physician provided the final opinion.

36. If the person to be checked up does not agree with the results of the medical check-up, and the first check-up has been performed in a specialised medical treatment institution, the person is entitled to request, within a month, a repeat laboratory investigation of biological environment. After receiving the results of the repeat laboratory investigations, the final opinion shall be provided by another physician of the specialised medical treatment institution.

IV. Determination of the Influence of Alcohol, Narcotic, Psychotropic or Toxic Substances when Providing Medical Aid to a Patient Who has Been Injured

37. If a natural person has suffered an injury as a result of a road traffic accident, accident at work, or another injury, and has been taken to a medical treatment institution for medical assistance, the physician providing the medical assistance shall indicate in the patient's in-patient or out-patient medical card (medical documentation), whether the person is showing any clinical signs of consumption of alcohol, narcotic, psychotropic or toxic substances, as well as provide information on the taking of samples of biological environment for the determination of a particular substance.

38. The medical treatment institution shall ensure the taking and storing of samples and performing laboratory investigations of biological environment samples in order to determine the possible presence of alcohol and, in case of clinical signs, other narcotic, psychotropic or toxic substances.

V. Procedures for Covering Expenses of a Medical Check-up

39. If a medical check-up is performed on the basis of the referral referred to in Paragraph 6 of this Regulation, the expenses of the medical check-up shall be covered by the referrer.

40. If a medical check-up is performed on the basis of the referral referred to in Paragraph 6 of this Regulation and during the medical check-up the blood alcohol concentration referred to in Paragraph 28 of this Regulation, or the condition referred to in Sub-paragraph 29.5, 29.6, 29.8, 29.9 or 29.10 of this Regulation are detected, the expenses for the medical check-up shall be covered by the person to be checked up by paying the relevant amount of money into the budget account of the referrer.

[25 June 2013]

41. If a medical check-up is performed on the basis of a submission of the person to be checked up, the expenses for the medical check-up shall be covered by the person to be checked up.

42. Expenses of a repeat medical check-up shall be covered by the requester of the check-up.

43. The transfer of funds to the account of the relevant medical treatment institution shall be ensured by the referrer, but if the medical check-up is performed on the basis of a submission of the person to be checked up - by the person submitting the submission.

VI. Closing Provisions

44. Cabinet Regulation No. 625 of 23 August 2005, Procedures for the Detection of the Influence of Alcohol, Narcotic, Psychotropic and Toxic Substances (Latvijas Vēstnesis, 2005, No. 135; 2007, 11, No. 206), is repealed.

45. In relation to the State Probation Service, this Regulation shall apply as of 1 July 2009.

46. Paragraph 5 of this Regulation regarding the certificate of medicinal and diagnostic methods of a physician shall come into force on 1 January 2009.

Prime Minister I. Godmanis

Acting for the Minister for Justice -
Minister for Economics K. Gerhards

 

Annex 1
Cabinet Regulation No. 394
2 June 2008

Medical Treatment Institutions in which Medical Check-up for the Determination of the Influence of Alcohol, Narcotic, Psychotropic or Toxic Substances is Performed

[20 September 2011]

1. State limited liability company "Rīgas psihiatrijas un narkoloģijas centrs".

2. State limited liability company "Slimnīca "Ģintermuiža"".

3. Limited liability company "Jūrmalas slimnīca".

4. Limited liability company "Liepājas reģionālā slimnīca".

5. Limited liability company "Rēzeknes slimnīca".

6. Limited liability company "Aizkraukles slimnīca".

7. Limited liability company "Alūksnes slimnīca".

8. Limited liability company "Bauskas slimnīca".

9. Limited liability company "Cēsu klīnika".

10. Limited liability company "Dobeles un apkārtnes slimnīca".

11. Limited liability company "Jēkabpils reģionālā slimnīca".

12. Limited liability company "Krāslavas slimnīca".

13. Limited liability company "Kuldīgas slimnīca".

14. Limited liability company "Priekules slimnīca".

15. Limited liability company "Ludzas rajona slimnīca".

16. Limited liability company of the local government of Madona municipality "Madonas slimnīca".

17. Limited liability company "Ogres rajona slimnīca".

18. Limited liability company "Preiļu slimnīca".

19. Limited liability company "Saldus medicīnas centrs".

20. Limited liability company "Tukuma slimnīca".

21. Limited liability company "Vidzemes slimnīca".

22. Limited liability company "Ziemeļkurzemes reģionālā slimnīca".

23. Limited liability company "Balvu un Gulbenes slimnīcu apvienība".

24. Limited liability company "Daugavpils reģionālā slimnīca".

 

Annex 2
Cabinet Regulation No. 394
2 June 2008

Referral for a Medical Check-up

	(name of the medical treatment institution)

Please perform a medical check-up for
	(given name, surname)

 

Personal identity number

-

Address

Reason for check-up
	(for example, attending work under the influence of alcohol, narcotic, psychotropic, toxic or other substances, provision of medical assistance)

Determination of the fact of alcohol consumption

Determination of the fact of consumption of narcotic, psychotropic, toxic or other substances

(specify the substance group)

Referrer:
Place of employment
Given name, surname
Position
Date
Signature

After the medical check-up, please issue a medical check-up report to

(given name, surname)

I have received the medical check-up report
	(signature and full name)

Date:

Acting for the Minister for Justice -
Minister for Economics K. Gerhards

 

Annex 3
Cabinet Regulation No. 394
2 June 2008

Submission Regarding Performing a Medical Check-up

	(name of the medical treatment institution)

Please perform a medical check-up for
	(given name, surname)

 

Personal identity number

-

Address

Reason for check-up
	(for example, attending work under the influence of alcohol, narcotic, psychotropic, toxic or other substances, provision of medical assistance)

Determination of the fact of alcohol consumption

Determination of the fact of consumption of narcotic, psychotropic, toxic or other substances

(specify the substance group)

After the medical check-up, please issue a medical check-up report to

(given name, surname)

I have received the medical check-up report
	(signature and full name)

Date:

Acting for the Minister for Justice -
Minister for Economics K. Gerhards

 

Annex 4
Cabinet Regulation No. 394
2 June 2008

Individual Check-up Report No. ______

(date)

(place of check-up)

I,

,

(institution, position, given name, surname)

by using a portable measuring device for the determination of alcohol concentration in the exhaled air

,

(name, number and the last date of testing)

have checked

,

(given name, surname)

Personal identity number

-

who
		(reason for testing)

The first measurement:	was started		year	___.___________	time
	was completed		year	___.___________	time

Reading of the portable device for the determination of alcohol concentration in the exhaled air __________ per mille

The second measurement:	was started		year	___.___________	time
	was completed		year	___.___________	time

Reading of the portable device for the determination of alcohol concentration in the exhaled air __________ per mille

Printouts No. ______ and No. ______ of measurements of the portable device for the determination of alcohol concentration in the exhaled air have been attached to the report.

Official
	(signature and full name)

This part of the report shall be filled out by the person checked

I,		agree with the results of the performed check-up
	(given name, surname)

Person checked
	(signature)

Acting for the Minister for Justice -
Minister for Economics K. Gerhards

 

Annex 5
Cabinet Regulation No. 394
2 June 2008

Taking of Samples of Materials for Laboratory Investigations and Storage Thereof

[25 May 2012]

I. Taking of Samples of Materials for the Determination of Alcohol in the Biological Environment and Storage Thereof

1. For a blood sample, 15-20 ml of blood shall be taken from the superficial vein in vacutainer, which has been treated with heparin.

2. The skin at the place of puncture shall be treated with furaciline solution (1:5000), rivanol solution (1:500) or another alcohol-free disinfecting solution. It is prohibited to treat the skin with ether and other alcohol solutions.

3. Immediately after taking of the blood sample, the content of vacutainer shall be shaken lightly several times.

4. For a urine sample, 15-20 ml of urine shall be taken in a dry disposable container, leaving as little air above the surface of the sample as possible. The container shall be hermetically sealed off.

5. For a saliva sample, 10 ml of saliva shall be taken in a dry disposable container, leaving as little air above the surface of the sample as possible. The container shall be hermetically sealed off.

6. Containers and vacutainers with samples shall be stamped and stored in a refrigerator where the temperature is not higher than 4°C.

7. There shall be a label on each container and vacutainer with the sample number, the date and time of sampling, the given name, surname, year of birth or personal identity number of the person to be checked up, and the given name and surname of the medical practitioner who took the sample.

8. The part of the sample left after laboratory investigations shall be hermetically sealed and stored for 35 days in a refrigerator where the temperature is not higher than 4°C for the purpose of possible control investigations. After expiration of the abovementioned term, the sample shall be destroyed and a deed regarding writing off shall be drawn up. If a justified submission of the person referred to in Paragraph 6 or 7 of this Regulation is received, the period of time for storing the sample shall be extended up to 70 days from the date of sampling, and the material shall be placed in a freezer compartment.

II. Taking of Samples of Materials for Chemical-toxicological Investigation and Storage Thereof

9. For a urine sample, 100-200 ml of urine shall be taken in a dry disposable container. The container shall be covered with a lid. Preservatives are not necessary for urine samples.

10. For a blood sample, 20-30 ml of blood shall be taken from the superficial vein in vacutainer, which has been treated with heparin.

11. The skin at the place of puncture shall be treated with furaciline solution (1:5000), rivanol solution (1:500) or another alcohol-free disinfecting solution. It is prohibited to treat the skin with ether or other alcohol solutions.

12. Immediately after taking of the blood sample, the content of vacutainer shall be shaken lightly several times.

13. For a saliva sample, 10 ml of saliva shall be taken from the person who is suspected for using narcotic substances.

14. After taking of the saliva sample, the oral cavity shall be rinsed with 10-20 ml of 70% ethyl alcohol (to prevent swallowing, the alcohol shall be saturated with sodium chloride).

15. Saliva and the rinsing substance referred to in Paragraph 14 of this Annex shall be mixed together in the same container.

16. In the case referred to in Paragraph 13 of this Annex, the rinsing substance shall also be taken from the hands of the checked person. The rinsing substance from palm and fingers shall be obtained by scrubbing them with a wad immersed in a 70% ethyl alcohol.

17. The wad shall be packaged separately from the rinsing substances and saliva (a clean wad which has been packaged separately shall also be sent for investigation).

18. The saliva sample and rinsing substances shall be taken after investigation of the person and after taking of samples for the determination of alcohol concentration.

19. Containers and vacutainers with samples shall be stored for 35 days from the date of sampling in a refrigerator where the temperature is not higher than 4°C. After expiration of the abovementioned term, the sample shall be destroyed and a deed regarding writing off shall be drawn up. If a justified submission of the person referred to in Paragraph 6 or 7 of this Regulation is received, the period of time for storing the sample shall be extended up to 70 days from the date of sampling, and the material shall be placed in a freezer compartment.

20. Samples, which are investigated in order to determine cocaine, tranquillizers and tropane alkaloids, shall be immediately frozen and stored in the freezer.

21. There shall be a label on each container and vacutainer with the sample number, the date and time of sampling, the given name, surname, year of birth or personal identity number of the person to be checked up, the referral report number, the name of the substance, for the determination of which the investigation is intended, and the given name and surname of the medical practitioner who took the sample.

Acting for the Minister for Justice -
Minister for Economics K. Gerhards

 

Annex 6
Cabinet Regulation No. 394
2 June 2008

Referral for Determination of Alcohol in the Biological Environment

Please, investigate

blood

urine

saliva

Person
	(given name, surname and personal identity number or year of birth)
	(address)

State of affairs

Physician's report No.

drawn up on

year

___.____________

Alcohol concentration detected in the exhaled air ______ per mille

Referrer

Samples were taken on		year	______.________________	time
sample No.
	(according to the register entry)

The place of puncture until taking of the blood sample was treated with

Samples were stored in room temperature/refrigerator (underline as appropriate)
Samples have been preserved	no
	yes
		(specify preservative and amount thereof)
The following medicinal products containing alcohol have been used
			(name, amount)

The medical practitioner
	(given name, surname, signature, stamp)

	(date)

(name, address and telephone number of the medical treatment institution)

Samples - blood urine saliva - have been delivered to the laboratory on
	year	________._________________________	time

sample No.
	(according to the register of laboratory)
(conveyer,
(description of samples of materials, damages thereof and other features)

Received by
	(position, signature and full name)

Acting for the Minister for Justice -
Minister for Economics K. Gerhards

 

Annex 7
Cabinet Regulation No. 394
2 June 2008

Referral for Chemical-toxicological Investigation

Please, investigate
	(name of the sample)

Person
	(given name, surname and personal identity number or year of birth)
(address)

The objective of the investigation
		(specify the substance and the group of substance)
State of affairs

Data of medical check-up
	(traces of injection and other signs, clinical diagnosis)

The following medicinal products used
	(name, amount)

Physician's report No. ______, drawn up on ___ ___________ ____ (date, month, year), case-record No. _____

Referrer

Samples were taken on ___ ___________ ____ (date, month, year) at _________ (time)

The place of puncture until taking of the blood sample was treated with

Samples were stored in room temperature/refrigerator (underline as appropriate)

Samples have been preserved	no
	yes
		(specify preservative and amount thereof)

The medical practitioner
	(given name, surname, signature, stamp)

____________________ (date)

(name, address and telephone number of the medical treatment institution)

Samples				have been delivered to the laboratory
	(name, amount)
		year	________._________________________		time

sample No.
	(according to the register of laboratory)
(conveyer,
defects of packaging or seals, and other features)

Received by
	(position, signature and full name)

Acting for the Minister for Justice -
Minister for Economics K. Gerhards

 

Annex 8
Cabinet Regulation No. 394
2 June 2008

Medical Check-up Report No. ________ for the Determination of the Influence of Narcotic, Psychotropic or Toxic Substances

___ _____________ ______________ (date) ______________

1. Given name, surname

 

2. Personal identity number

-

 

3. Date of birth (dd, mm, yyyy)

 

4. Place of employment and position

 

5. Who and when (exact time) is referring for a medical check-up

6. Place and exact time of the medical check-up

7. Who performed the medical check-up (given name and surname of the physician)

8. Outer appearance of the person to be checked up: condition of clothing, visual examination (for example, intravenous injection sites, injuries, bruises)

9. Vegetative-somatic reactions of blood vessels (condition of skin and mucous membranes, scleral hyperemia, tongue, salivation, profuse sweating)

10. Breathing (accelerated/decelerated)

11. Pulse rate

12. Arterial tension

13. Pupils (narrowed, widened, pupillary response to light)

14. Nystagmus

15. Muscular movement

16. Facial expression (weak/vivid)

17. Gait, Romberg test

18. Exact movements (pick up a coin, touch the tip of the nose blindfolded)

19. Tremor in arms, eyelids, tongue

20. Muscle tone, pain sensation

21. Tendon reflexes

22. Cognitive condition (orientation in place, time, environment, own personality)

23. Thinking

24. Emotions

25. Perception

26. Memory

27. Behaviour of the person to be checked up

28. Speech ability

29. Possible psychotic disorders, illusions, hallucinations, nightmares and other disorders

30. Information on the use of narcotic, psychotropic, toxic and other substances: subjective/objective (according to documents and other sources)

31. Biological environment (blood, urine, saliva, rinsing substances from mouth and hands)
Time when the sample was taken

Signature of the person to be checked up
	(the signature of the person to be checked up also confirms the fact that the check-up has been performed for this person exactly)

32. Results of laboratory investigations

33. Opinion

34. Types and price of investigations according to the price-list of the relevant medical treatment institution

(types, price)

Physician who detected the influence of narcotic, psychotropic or toxic substances

(signature and full name)

Medical treatment institution's
stamp

Acting for the Minister for Justice -
Minister for Economics K. Gerhards

 

Annex 9
Cabinet Regulation No. 394
2 June 2008

Medical Check-up Report No. ____ for the Determination of the Influence (Concentration) of Alcohol

___ ________________ _____ (date)

1. Given name, surname

 

2. Personal identity number

-

3. Place of employment and position

4. Who and when (exact time) is referring for a medical check-up

5. Place and exact time of the medical check-up

6. Who performed the medical check-up (given name and surname of the physician)

7. Reasons for the performance of medical check-up (for example, attending work under the influence of alcohol, determination of the influence of alcohol)

8. Outer appearance of the person to be checked up: condition of clothing, visual examination (for example, injuries, bruises)

9. Behaviour of the person to be checked up (tense, reserved, increased excitability, excited, aggressive, euphoric, talkative, restless, unstable mood, sleepy, delayed, complaining about his or her condition (specify))

10. Cognitive condition (orientation in place, time, environment, own personality)

11. Speech ability (coherent story, articulation disorders, incoherent speech)

12. Vegetative-somatic reactions of blood vessels (condition of skin and mucous membranes, scleral hyperemia, tongue, salivation, profuse sweating)

13. Breathing (accelerated/decelerated)

14. Pulse rate

arterial tension

15. Pupils (narrowed, widened, pupillary response to light)

16. Nystagmus
Muscular movement

17. Facial expression (weak/vivid)

18. Gait (staggering, unsteady), walking with sharp turns (swinging in turns), Romberg test

19. Exact movements (pick up a coin, touch the tip of the nose blindfolded)

20. Tremor in arms, eyelids, tongue

21. Signs of neuropsychological diseases (signs of organic damage of CNS, as well as physical weakness)
Injuries suffered (according to the words of the person to be checked up)

22. Information on the last fact of use of alcohol and medicinal substances: subjective/objective (according to documents and other sources)

23. Odour of alcohol or other substance from the mouth

24. Presence of alcohol or other substance in the exhaled air and biological bodily environments:
24.1. the exhaled air was tested using a portable measuring device for the determination of alcohol concentration in the exhaled air
(name of the portable measuring device)
time and results of the test

24.2. repeated test (time and results of the test)

24.3. biological environment(s) (blood, urine, saliva) was sampled

24.4. time when the sample was taken

Signature of the person to be checked up
	(the signature of the person to be checked up also confirms the fact that the check-up has been performed for this person exactly)

24.5. testing methods
time when testing was performed
results of the test

25. Other data from the medical check-up or current documentation

26. Opinion

27. Types and price of investigations according to the price-list of the relevant medical treatment institution

(types, price)

Physician who determined the influence of alcohol
	(signature and full name)

Medical treatment institution's
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Acting for the Minister for Justice -
Minister for Economics K. Gerhards

 

Annex 10
Cabinet Regulation No. 394
2 June 2008

Results of a Chemical-toxicological Examination No. ____
(Annex to the Medical Check-up Report No. ____)

1. Referrer
	(institution, position, given name, surname)

2. Received by
	(institution, position, given name, surname)

3. Person to be checked up
(given name, surname, personal identity number or year of birth, place of residence)

4. Biological environment to be investigated

5. Sample was taken on
	(dd.mm.yy, time)

6. Sample was received on
	(dd.mm.yy)

7. Investigation was finished on
	(dd.mm.yy)

8. Opinion:

9. Types and price of investigations according to the price-list of the relevant medical treatment institution

(types, price)

Expert of forensic medicine-specialist
	(signature and full name)

Acting for the Minister for Justice -
Minister for Economics K. Gerhards

 

Annex 11
Cabinet Regulation No. 394
2 June 2008

Institution

Register of Persons for Whom Influence of Alcohol, Narcotic, Psychotropic or Toxic Substances has been Detected

Started on ______ ___________________ ______

Completed on ______ ___________________ _______________ _______________

No.	Date	Given name, surname	Date of birth	Address	Place of employment and position	Personal identification document	Type of examination	Referrer	Place and time of examination	Analysis of biological environment and results thereof	Opinion	Signature of the doctor
1	2	3	4	5	6	7	8	9	10	11	12	13

Acting for the Minister for Justice -
Minister for Economics K. Gerhards

 

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Translation © 2015 Valsts valodas centrs (State Language Centre)