Non-DOT Drug Testing Service Request

Non-DOT Drug Testing Service Request

Use this secure form to request non-DOT drug testing for an employee or candidate. Please submit one request per donor. Orders received during business hours are processed as quickly as possible. Requests submitted after 5:00 PM Central Time, on weekends, or on holidays will be processed the next business day.
Employer Information
Company Name
Requestor Name
Requestor Email
example@example.com
Requestor Phone
Please enter a valid phone number.Format: (000) 000-0000.
Department
Do you need to submit testing orders for multiple donors right now?
Donor Information
Donor Information
Donor/Employee/Candidate Full Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Employee ID
Employee Phone
Please enter a valid phone number.Format: (000) 000-0000.
Employee Email Address
example@example.com
Donor City, State, and ZIP Code

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Testing Order
Test Reason

Other
Test Requested
Desired Collection Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Desired Collection Time
Preferred Method for Donor Registration
After the order is processed, the donor or employer will receive instructions for completing the test at an authorized collection site. KingOps Group can help identify a convenient location based on the donor’s city and ZIP code.
Submitting this form does not confirm that an appointment or testing order has been scheduled. KingOps Group will send registration details or contact the requestor if additional information is needed. Do not include a Social Security number or medical information in the Special Instructions field.
Special Instructions
Authorization
Order Authorization Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Non-DOT Drug Testing Service Request

Donor Information

Testing Order