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From: Robert Swotinsky MD
Date: 17 Nov 2005
Time: 10:17:45 -0800
Remote Name: 65.206.105.12
Report the first refusal to test. (Sounds like you've already done that.) Perform the second test pursuant to the DER's request. Ask the DER what "type" to make the second test -- the DER will probably tell you it's a random. Don't forget to bill for both events - the first test (outcome refusal to test) and the second test (outcome as yet unknown).
You'll be concerned that the DER won't take the designated action based on the refusal to test. But, beyond educating the DER (as you've already done), you're not going to able to make the DER take action based on it. While educating clients in a nice way is a good thing, reporting them to regulatory or enforcement agencies to try and force their hand is probably not appropriate in this setting.