Company Drug Testing Payment

Company Drug Test/Consortium Payment

Fill out the form carefully for registration
Company/Client Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Client E-mail*
example@example.com
Phone Number*
Additional Comments - List Names of Employees Included in this Payment

Options - Payment is required in advance for any services*

Drug Test Only Product Image

Drug Test Only

USCG/DOT Compliant - 5 Panel Urinalysis

$70.00 Quantity

Drug Test and 1 Year Consortium Membership Product Image

Drug Test and 1 Year Consortium Membership

USCG/DOT Compliant - 5 Panel Urinalysis and 1 Year Random Drug Testing Program

$130.00 Quantity

1 Year Consortium Membership Product Image

1 Year Consortium Membership

1 Year Random Drug Testing Program - New or Renewal

$70.00 Quantity

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

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