Drug Order COC Forms Band 1

Order Drug Testing Forms

    Requester Name (required)

    Email Address (required)

    Phone Number (required)

    Company Name (required)

    Location / Department

    Mailing Address - No PO Boxes for FedEx (required)

    Address 2

    City (required)

    State (required)

    ZIP Code (required)

    Quantity Needed:

    Urinalysis

    Urinalysis - DOT (Department of Transportation)

    Hair

    Method of Delivery:
    US Mail or FedEx Ground (No Charge)FedEx Overnight AMFedEx Overnight PMFedEx 2nd Day

    FedEx Billing Number

    Other comments or special instructions

    If no FedEx number is given, we will bill all FedEx charges on your regular invoice.

    If you are in the Dallas area and would like same day delivery via courier, please call us to make arrangements - 972-701-8603.

    Note: Orders received after 3:00pm CST will be processed the next business day.