Midlands Testing Services, Inc. Supply Request Form

Midlands Testing Services, Inc. Supply Request Form

Please fill out the following form to submit a supply request to Midlands Testing Services, Inc. Do NOT wait until the last minute to order your supplies, as it can take over a week for you to receive them. If you have any questions please contact the call center at (402) 983-9590.
Name*

First NameLast Name
Email*
example@example.com
Shipping Address*

Street Address

Street Address Line 2

CityState

Zip Code
INSTRUCTIONS

Please select the items that you need to re-order below. Supplies are listed by company, if you need items from more than one company please select multiple.
Alcohol Testing Forms
DOT ATF's

AmtrakBelt Railway Company of ChicagoBNSFBoeingCanadian NationalConrailCSXGenericG&W (GRSI)Norfolk SouthernOmniTRAXP&L Evansville WesternP&L Midway SouthernP&L Appalachian & OhioPan Am RailwaysSkyWest AirlinesSouthwest AirlinesTranstarUnion Pacific
NON-DOT ATF's

AmtrakBelt Railway Company of ChicagoBNSFBoeingCanadian NationalConrailCSXGenericG&W (GRSI)Norfolk SouthernOmniTRAXP&L Evansville WesternP&L Midway SouthernP&L Appalachian & OhioPan Am RailwaysSkyWest AirlinesSouthwest AirlinesTranstarUnion Pacific
Urine Chain of Custody Forms
DOT CCF's

Alton & SouthernAmtrakBelt Railway Company of ChicagoBNSFBoeingCanadian NationalConrailCSXElite Team LogisticsFort Wayne Railroad Historical SocietyGreat Lakes Central RailroadG&W (GRSI)New Orleans Public Belt RailroadNorfolk SouthernOmniTRAXP&L Evansville WesternP&L Midway SouthernP&L Appalachian & OhioPan Am RailwaysSkyWest AirlinesSouthwest AirlinesSun Country AirlinesTranstarUnion Pacific
NON-DOT CCF's

Alton & SouthernAmtrakBelt Railway Company of ChicagoBNSFBoeingCanadian NationalConrailCSXElite Team LogisticsFort Wayne Railroad Historical SocietyGreat Lakes Central RailroadG&W (GRSI)New Orleans Public Belt RailroadNorfolk SouthernOmniTRAXP&L Evansville WesternP&L Midway SouthernP&L Appalachian & OhioPan Am RailwaysSkyWest AirlinesSouthwest AirlinesSun Country AirlinesTranstarUnion Pacific
Instant Testing Forms

Boeing Non-DOTGeneric Non-DOT
Southwest Testing Notification Forms

Drug NotificationAlcohol NotificationFAA Required Direct Observation
Urine Collection Supplies
Urine Cups

YesNo
CRL FormFox Labels

YesNo
Instant Testing Kits

CaltrainCanadian NationalCapMetroKansas City StreetcarOklahoma City StreetcarTri-Rail
BOEING QUEST RAPID RESULTS CUPS

YesNo
Oral Fluids Supplies
Oral Fluids

Canadian National - Quantisal IUnion Pacific - Quantisal II
Shipping Supplies
CRL - Shipping Labels

YesNo
Quest - Shipping Labels

YesNo
Medtox Shipping Labels

YesNo
FedEx Shipping Bags

YesNo
Notes
Quantity On Hand, Quantity Requests, Urgency, etc.
Please verify that you are human*
Should be Empty:

Midlands Testing Services, Inc. Supply Request Form

INSTRUCTIONS

Alcohol Testing Forms

Urine Chain of Custody Forms

Urine Collection Supplies

Oral Fluids Supplies

Shipping Supplies