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Influence Form


Have an alcohol citation completed then click the Replicate button to open an Influence form. Some fields from the citation will auto populate the Influence form. There’s an Interrogation Report available for printing at any time. The form can be deleted at any time.

This form is owned by Department the Division of State Patrol - Chemical Test Unit.


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DSP Chemical Test Unit
DSP Chemical Test Unit

The Influence form is printed and isn’t transmitted outside agencies. The form may be transmitted to get into Records Management Systems (RMS) if configured. This form is owned by Department of State Patrol Chemical Test Unit

The Influence form contains these groups:

How to:

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Agency Tables associated with form

Document Group

Each Influence form contains one Document group. The fields within the group are shown in the figure below. The Date Reported field is the date the influence form was filled out.

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Individual Group

Each Influence form contains one Individual group. The fields within the group are shown in the figure below. The Date and time fields along with the Citation number field will have auto populated if the replicate feature was used.

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Opinions Group

Each Influence form contains one Opinions group. The fields within the group are shown in the figure below.

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Questions Group

Each Influence form contains one Questions group. The fields within the group are shown in the figure below.

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Comments Group

Each Influence form contains one Questions group. The fields within the group are shown in the figure below.

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Agency Group
Agency Group

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Attachment Group
Attachment Group